[Effects of the anticholinesterase drug neuromidin in patients with schizophrenia with marked neurocognitive deficits].

An objective of the study was to investigate the effectiveness of neuromidin in stable schizophrenic patients with predominance of symptoms of pseudoorganic deficits. Fifty-five patients stable after a transition from routine medication to monotherapy with risperidone were randomized into two groups with add-on placebo or neuromidin treatment. Patients were studied during 24 weeks. The PANSS and a battery of neurocognitive tests were used for assessment of treatment. In the end of the trial, positive changes on the following PANSS items - N1, N2, N6, N7, G4, G7 and G13 were observed in the neuromidin group. In the placebo group, the changes were found only on one PANSS item - N2. The decrease of scores on this item (emotional withdrawal) during the study was more significant only in the patients receiving neuromidin (p=0,037). The results of assessment of cognitive functioning showed the positive changes in visual-spatial memory, attention, retention and retrieval of data, planning in the group treated with neuromidin. In the placebo group, the positive changes were observed only in one index - one type of mistakes (omissions) in visual-spatial memory test. In the end of the trial, between-group differences were significant for planning - number of tasks with time-limit violation and rule violations. All differences were beneficial for patients treated with neuromidin. Not all tests were sensitive to changes in cognitive status of patients: indices of working memory, psychomotor speed, flexibility of attention were not changed significantly in both groups, nor they changed between groups. The authors conclude that the problem of rationality of add-on anticholinergic treatment in schizophrenia is not solved yet due to the difficulties in selection of patients and tests for cognitive assessment. The need of further studies is emphasized.