Symptomatic thinking: the current state of Phase III and IV clinical trials for cognition in schizophrenia

• Published in: Drug discovery today Vol. 22; no. 7; pp. 1017 - 1026
• Main Author: Talpos, John C.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-07-2017
• Subjects: Antipsychotic Agents - therapeutic use; Clinical Trials, Phase III as Topic; Clinical Trials, Phase IV as Topic; Cognition Disorders - drug therapy; Drug Repositioning; Humans; Schizophrenia - drug therapy
• ISSN: 1359-6446; 1878-5832
• DOI: 10.1016/j.drudis.2017.04.014

•Currently there are no novel compounds undergoing PIII or PIV clinical trials for cognition in schizophrenia.•Most clinical research aimed at developing treatments for cognition in schizophrenia is focused on agents established for other indications.•Repositioning of compounds is not in itself inherently problematic, but many of these lack an empirically driven rational.•Finding an effective pharmacological treatment for impaired cognition in schizophrenia does not seem likely.•A succession of negative findings is likely to further decrease investment in the field.
Research indicates that relieving the cognitive and negative symptoms of schizophrenia is crucial for improving patient quality of life. However effective pharmacotherapies for cognitive and negative symptoms do not currently exist. A review of ongoing Phase III clinical trials indicates that, despite numerous compounds being investigated for cognition in schizophrenia, few are actually novel and most are not backed by empirically driven preclinical research efforts. Based on these trials, and a general disinvestment in development of novel therapies for schizophrenia, the likelihood of a major advancement in treating cognitive differences in schizophrenia does not look promising. Possible ways in which the remaining resources for development of novel treatment for schizophrenia can best be leveraged are discussed.
Despite incredible advances in our understanding of the brain and how it is affected by disease, disinvestment is compromising the future of scientific innovation for the treatment of cognitive deficits in schizophrenia.