A double-blind placebo-controlled case study of the use of donepezil to improve cognition in a schizoaffective disorder patient: Functional MRI correlates

Cognitive impairment in multiple domains is common in patients with schizop hrenia and may be a powerful determinant of poor functional ability and qua lity of life. We report a double-blind, placebo-controlled, cross-over stud y of donepezil augmentation in a schizoaffective disorder patient stabilize d on olanzapine pharmacotherapy. The patient showed significant improvement s in several cognitive measures and increased activation of prefrontal cort ex and basal ganglia on functional MRI during the donepezil augmentation. I n addition, the donepezil augmentation resulted in a reduction of depressiv e symptoms and in significant improvements in functional abilities and qual ity of life. Further studies of donepezil augmentation of neuroleptics in s chizophrenia are warranted.