Program to improve cognitive functioning in patients with schizophrenia: reflections.

Cognitive dysfunction in patients who suffer from schizophrenia is a major clinical problem. For such patients, the neurobiological cause(s) for the cognition deficits are not clear. Treatments with high doses of compounds that work at the coagonist site of the NMDA receptor have demonstrated that some degree of improvement can be elicited in patients. Thus, the NIMH effort to delineate the clinical responses that would allow new drugs to be registered for this use is very timely. Significant credit is due Dr. Steven Hyman and his colleagues for stimulating this bold initiative. Many problems remain to be solved to accomplish the goal. This article articulates a few such problems.