Comparison of Neurocognitive Effects of Blonanserin, Olanzapine, Aripiprazole, and Risperidone in Drug-Naïve First-Episode Schizophrenia

Background: Neurocognitive deficits are a core feature of schizophrenia.The specific impact of antipsychotics on neurocognitive function in drug-nave first-episode schizophrenia (FES) remains unclear, especially for newer agents like blonanserin.This study compared the neurocognitive effects of blonanserin, olanzapine, aripiprazole, and risperidone during the first 6 months of treatment in FES patients.Study Design: Data were derived from two clinical trials in which FES patients received initial treatment with blonanserin, olanzapine, aripiprazole, or risperidone.Neurocognitive function was assessed at baseline and 6 months using multiple measures.Paired t-tests evaluated within-group changes, and repeated measures ANOVA examined differential effects across groups.Study Results: Of 594 recruited patients, 294 completed follow-up.All four groups showed comparable improvements in processing speed and working memory.A significant group-by-time interaction was observed for verbal (p = 0.005) and visuospatial memory (p = 0.054).Notably, blonanserin-treated patients demonstrated greater improvements in verbal learning (p = 0.005) and visuospatial memory (p = 0.045) compared to risperidone.Conclusion: Initial antipsychotic treatment in drug-nave FES patients is associated with neurocognitive benefits, particularly in processing speed and working memory.Furthermore, blonanserin may offer advantages in ameliorating learning and memory deficits compared to risperidone.