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November 1988

Prefrontal-Type Cognitive Deficits and Chronic Psychiatric Conditions-Reply

Author Affiliations

Clinical Brain Disorders Branch Intramural Research Program National Institute of Mental Health Neuropsychiatry Hospital 2700 Martin Luther King, Jr, Ave SE Washington, DC 20032

Arch Gen Psychiatry. 1988;45(11):1054-1055. doi:10.1001/archpsyc.1988.01800350088018

—Dr Wong raises a number of points that are germane to our study. The first relates to the possibility that prefrontal-type cognitive deficits in patients with chronic schizophrenia may be related to the use of neuroleptic medication. We do not believe that neuroleptic medication markedly influenced our results. Be fore the introduction of neuroleptic drugs, cognitive deficits of the type we found were noted by Fey1 and by Kendig and Richmond.2 A number of studies3,4 have found that neuroleptic drugs affect neither IQ nor neuropsychological testing performance to any great degree, though they do have a markedly positive effect on thought disorder, hallucinations, and delusions. Moreover, Berman et al5 found that neuroleptic drugs did not appreciably change blood flow in schizophrenic patients while they performed the WCS. This dissociation in responsiveness to neuroleptic drugs between florid psychotic symptoms on the one hand and cognitive impairment on

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