Adjunctive Methylphenidate ER in Patients With Schizophrenia to Improve Functional and Cognitive Outcomes

Prior treatment

• Have had treatment with ECT in the past 6 months
• Have a history of previous safety concerns directly driven by positive symptoms (e.g history of suicide attempt as directed by auditory hallucinations)

Other illness

• Have a history of traumatic brain injury
• Have a contraindication to psychostimulants including:
  • Uncontrolled hypertension
  • Significant cardiovascular abnormality including history of cardiac interventions, history of myocardial infarction, unstable arrhythmia, congenital heart disease
  • Known family history of premature cardiac death (for males \<45, females \<55)
  • Known history of glaucoma
• Have any of the following diagnoses: neurodevelopmental delay, intellectual disability or neurocognitive disorder (dementia)
• Have a diagnosis of another currently significant and unstable psychiatric condition (i.e. depressive episode, active substance use disorder, etc.)

Other

• Have known sensitivity to methylphenidate ER, as documented in the electronic medical record OR, as reported by the patient AND verified by pharmacy
• Are currently pregnant or planning to become pregnant- a rapid urine pregnancy test will be done for female participants, and a refusal to take the test or a positive test will exclude the participant
• Have a diagnosis of substance induced psychosis
• Have current active suicidality

• Adult between the ages of 18-55; we chose an upper age limit of 55 years to exclude patients with potential age-related cognitive impairments which usually occur about a decade earlier in patients with schizophrenia
• Inpatient or outpatient with schizophrenia spectrum illness, on any antipsychotic medication
• Clinically stable for the past 4 weeks
• Able to communicate in English