I wanna see the drug that can “treat cognitive impairment in schizophrenia.” I’m sorry, by sz is not Alzheimers or even close. The underlying physiology is waaaaaay different.
Though I will say that it may be possible to treat certain physiological conditions that “get in the way” of functional cognition, I have to add that “correcting dysfunctional core beliefs and appraisal-according-to-belief schemas with meds” is pretty likely impossible.
Funny, I just ran into this an hour or so ago on CPN:
Interest in cognitive impairment in schizophrenia is driven, in part, by the recognition that cognitive impairment is more responsible than positive symptoms for the broadly and persistently observed impairments in functioning. Impairments are present in multiple cognitive domains, and most have a robust relationship with functioning.
Lepage M, Bodnar M, Bowie CR. Neurocognition: clinical and functional outcomes in schizophrenia. Can J Psychiatry. 2014;59(1):5-12.
Cognitive impairment is not due to, or secondary to, positive or disorganized symptoms—cross-sectional correlations between positive symptoms and cognition are negligible, while positive symptom improvement is not correlated with cognitive change in clinical trials. In addition, cognitive impairment in schizophrenia is present prior to any pharmacotherapy, and treatment-naive patients demonstrate serious cognitive impairment comparable to that of their treated counterparts. Thus, it appears that impaired cognition is an independent, core neurobiological feature of schizophrenia and should be a therapeutic target apart from reducing psychotic symptoms.
Nasrallah HA, Keefe RSE, Javitt DC. Cognitive deficits and poor functional outcomes in schizophrenia: clinical and neurobiological progress. Curr Psychiatry. 2014;13(6 suppl):S1-S11.
(Henry Nasrallah, who seems to be a tout for Big Pharma much of the time, is hopeful for a medicinal solution, but that figures.)
There are no pharmacologic or behavioral options that have received regulatory approval for the treatment of cognitive impairment in schizophrenia. At present, in the absence of effective treatments, the development of medications to treat cognitive impairment represents a serious public health need. The MATRICS initiative, or the Measurement and Treatment Research to Improve Cognition in Schizophrenia project, is an interdisciplinary collaboration that was initiated by the National Institute of Mental Health (NIMH) to support the development of pharmacologic agents to improve cognition in schizophrenia. Research into multiple pharmacologic mechanisms that may potentially alleviate cognitive impairment in schizophrenia is actively ongoing.
Buchanan RW, Davis M, Goff D, et al. A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia. Schizophr Bull. 2005;31(1):5-19.