MEMORY IMPAIRMENT IN SCHIZOPHRENIA - PERSPECTIVES FROM PSYCHOPATHOLOGY AND PHARMACOTHERAPY

Objective: To describe the concept of memory impairment in schizophren ia and the clinical implications of this concept in terms of patient a ssessment and neuroleptic drug use. Method: Narrative literature revie w. Results: Individuals suffering from schizophrenia normally exhibit some degree of memory impairment. Recent work in psychopathology indic ates that the impairment is comprehensive, involving the sensory, shor t-term, and long-term memory stores. Memory impairment appears to be a primary symptom of the disease, and its underlying causes are likely organic. A number of medications, however (for example, traditional ne uroleptics and drugs that have pronounced anticholinergic activity), m ay cause or exacerbate impairment. In particular, anticholinergic agen ts used to treat extrapyramidal symptoms. a common complication of neu roleptic drugs, appear to have a deleterious effect on memory. Conclus ions: Memory impairment is an important consideration in the clinical assessment and management of patients with schizophrenia. The use of a typical antipsychotics like risperidone appears to have no impact on m emory function; because risperidone is associated with a low incidence of extrapyramidal side effects, it can obviate the need for anticholi nergic medications-thus offering greater hope of nondebilitative inter vention. The advent of medications that are safer (on cognition) could also lead to generally better outcomes by facilitating compliance wit h drug regimens and rehabilitation programs.