Cognitive impairment is well documented in schizophrenia, and improves to some extent with treatment. Early cognitive changes in response to antipsychotic treatment are not well documented. We assessed early (12wk) cognitive changes and their relationships to psychopathology in 20 patients in an interim analysis of an ongoing study.

Patients with a first episode of schizophrenia underwent MATRICS Consensus Cognitive Battery assessment at baseline, 4 and 12wks. PANSS ratings were completed. Treatment with low doses of oral and depot flupenthixol was commenced.

The sample consisted of 4 females and 16 males, with an average age of 21,22 years. The mean modal dose of flupenthixol was 10mg 2 weekly IMI. Two patients were withdrawn due to side-effects. The average premorbid IQ of the sample was on the 91st percentile as estimated by the Vocabulary subtest of the WAISS. Early changes in attention and concentration from baseline were present. Other cognitive domains (speed of processing, working memory, and visual learning) also improved and were correlated with changes in PANSS scores.

Low doses of a long-acting conventional antipsychotic are effective in improving some aspects of cognitive function after a first episode of schizophrenia. The response was rapid, and coincided with improvement in positive symptoms. The failure of previous studies to demonstrate cognitive benefits of conventional antipsychotics may have been related to excessive doses being prescribed.