Antipsychotic Therapy Effects Cognition In Patients With Schizophrenia

Short-term adjunctive antipsychotic use does not affect cognition in patients with schizophrenia, according to the findings of a recent study. However, long-term use may have the opposite effect.

The study included 60 participants with schizophrenia enrolled in the Northern Finland Birth Cohort (1966) who completed an extensive series of cognitive tests at age 43 years. Medical records and interviews were used to collect lifetime and current usage of psychiatric medications. Linear regression was used to analyze associations between cognitive composite scores and medication use.
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Overall, the researchers’ analysis showed that lifetime cumulative defined daily dose years of benzodiazepine and antidepressant medication use was not significantly associated with global cognition. Participants who had not received antipsychotics for a minimum of 11 months before the cognitive tests had better cognitive performance.

After adjusting for gender, age of onset, and lifetime hospital treatment days, higher lifetime cumulative defined daily dose years of antipsychotic use was associated with poorer cognitive performance.

However, long antipsychotic-free periods that occurred early in a patient’s treatment history, antipsychotic polypharmacy, and other lifetime trends of antipsychotic use did not significantly affect cognition.

“Based on these naturalistic data, low exposure to adjunctive benzodiazepine and antidepressant medications does not seem to affect cognition nor explain the possible negative effects of high-dose long-term antipsychotic medication on cognition in schizophrenia,” the researchers concluded.

—Melissa Weiss

Reference:

Hulkko AP, Murray GK, Haapea MM, et al. Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966. Eur Psychiatry. 2017; 45: 50-58. http://dx.doi.org/10.1016/j.eurpsy.2017.06.004.