News Centre

Cognitive enhancement in schizophrenia

15 March 2004

University of Cambridge identifies potential treatment

Researchers from the Department of Psychiatry at the University of Cambridge recently identified a method of improving cognitive functioning in patients with schizophrenia, without the side-effects traditionally found with cognitive enhancers. Ms. Danielle Turner, together with colleagues from the University of Cambridge under the supervision of Prof. Barbara Sahakian, undertook research to explore the potential for a memory drug to improve cognition in patients with schizophrenia. The project received funding from the Wellcome Trust and the Medical Research Council. The work was published online on March 10 2004 at The American College of Neuropsychopharmacology website and is now in press in the journal Neuropsychopharmacology.

The study found that after taking a tablet of modafinil (Provigil�), patients with schizophrenia performed significantly better at memory tests involving short-term memory and, importantly, showed improved mental flexibility, a core deficit normally seen in patients with schizophrenia.

Modafinil is a medicine currently licensed in the UK for the treatment of a sleeping disorder called narcolepsy. Ms. Danielle Turner, Prof. Barbara Sahakian and others recently showed that modafinil improves mental functioning in healthy volunteers. This led the researchers to see whether modafinil might be of benefit to patients with schizophrenia. A group of 20 patients performed a number of memory tests once after they had taken a lactose placebo tablet and once after one 200 mg dose of modafinil.

After having taken modafinil, patients' short-term memory and cognition improved. For example, they were able to remember more numbers (similar to being asked to remember a telephone number) and they were able to learn new rules in a cognitive flexibility task (attentional set shifting) much more efficiently. This is similar to changing what you are doing when it is no longer the most efficient method. Using the telephone analogy, if you couldn't reach someone on the telephone, instead of repeatedly dialling the same number, you might try sending the person an email or a fax. Patients with schizophrenia can find it very difficult to switch from doing one thing to another. Difficulties in cognitive flexibility have been linked to an inability to fully rehabilitate in society, with many patients finding it impossible to hold down a full-time job or live alone.

These results are very promising because many patients with schizophrenia can find it very difficult to lead completely independent lives even after successful management of the hallucinations and other psychotic symptoms.

These results need to be confirmed in long-term studies of the effects of Modafinil in schizophrenia, to see whether these beneficial effects are maintained with chronic treatment. However, this study could have important implications for the treatment of schizophrenia.

Notes for Editors:

1. Full details of the paper are: Modafinil improves cognition and attentional set shifting in patients with chronic schizophrenia by Danielle C Turner, Luke Clark, Edith Pomarol-Clotet, Peter McKenna, Trevor W Robbins, Barbara J Sahakian. The paper can be accessed on the Internet at: http://www.acnp.org/.

2. Schizophrenia is a major psychiatric illness. It is estimated that one in every 100 people will suffer from the disorder, with about 24 million people world-wide affected. In terms of the World Health Organisation's Global Burden of Disease study, schizophrenia now ranks third of all psychiatric conditions, following depression and alcohol dependence.

3. The Department of Psychiatry is an internationally leading centre for research, teaching and clinical practice in most areas of psychiatry. More information can be found at: http://www.psychiatry.cam.ac.uk/.

4. Marjorie Wallace Chief Executive of SANE (www.sane.org.uk)

5. Previous press release: http://www.admin.cam.ac.uk/news/dp/2002110601

For more information, contact:

• 1. Danielle Turner, Department of Psychiatry University of Cambridge Tel: 01223 336010; email: dct23@cam.ac.uk

  2. Professor Barbara Sahakian, Department of Psychiatry University of Cambridge Tel: 01223 331209; email jenny.hall@addenbrookes.nhs.uk