A highlight from Cognitive Enhancers: The Brain on Chess

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Reader of every issued cognitive problems. One of the most common things. I see in practice whether the patient has booed disorder anxiety disorder. Schizophrenia or adhd. It's these problems with memory and concentration that bother than the most. They'll say. I forget what i went in the room for. I repeat things in conversation. It's so embarrassing. I'm overwhelmed and don't know where to start. These are the symptoms that cause patients to be unable to work and these kinds of symptoms often persist long after the episodes of psychosis depression or mania. Gone away patients often want to know if medications can help this or they asked directly for stimulant prescription. I would proceed with caution there but there is some hope. Most of the research on medications in cognition has been done in schizophrenia. And it's there that the cognitive problems have a name. Negative symptoms of schizophrenia. About two dozen medications have been tried in those cases and about half of them have had some success. Christopher corral and colleagues reviewed them for jam psych in two thousand seventeen but he concluded that the effect sizes were inversely correlated with the meta analysed study quality and that means that the worst. The design of the study the better. The medication looked the anti-depressants though did seem to help. Negative symptoms in schizophrenia. Particularly do locks a teen sim boca but the effect was small. That's interesting because we see a similar trend with those antidepressants in depression. Michael pasta neck wrote in february. Twenty nineteen issue that deluxe teen had the second best evidence the collision depression right. After forty occitania intel aches and forty oxidation just had controlled. Trial negative symptoms of schizophrenia. That michael reviewed in october twenty twenty issue but what about to mention medications a lot of my patients with bipolar disorder. Ask about those. There was some excitement in the bipolar field about those medications in the early. Two thousands and that culminated in two small controlled trials of gallant to mean and donepezil error. Sept- that looked at whether they could improve cognitive symptoms of bipolar disorder in youth amax stable by puller patients. Neither of these worked very well which is probably why the findings were not followed up later. Dough net bazil did nothing in the controlled on off experiment. Where patients served as their own controls and gallant demean. Did some good and did some harm. It improved memory but it reduced processing speed. Yeah that's in line with what. I generally see in practice when i try to treat cognitive symptoms of bipolar disorder with medications. I've seen people feel tired and slowed down on madonna. Fennell word finding problems on lamotrigine and trouble concentrating on lorenza darn but all of these also evidence to help cognition so i wonder if they are really helping some aspects of cognition while harming others or the results simply vary a lot by patient. I guess it's probably a little bit of both. We've to dr diagnoses over the years. In part based on how people respond to medications with certain diagnoses that was how mood disorders. Which used to be lumped in one category of manic. Depression got split into in nineteen eighty. The ones who responded better to mood stabilisers were called bipolar and the ones who responded better to antidepressants record unicolor. But we don't have anything like that kind of diagnostic precision with cognitive symptoms. So things can get pretty unpredictable when we start to use so-called cognitive enhancing medications and psychiatric patients. What's right for one may be wrong

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