Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966

• Published in: European Psychiatry
• Main Authors: Hulkko, A.P., Murray, G.K., Moilanen, J., Haapea, M., Rannikko, I., Jones, P.B., Barnett, J.H., Huhtaniska, S., Isohanni, M.K., Koponen, H., Jääskeläinen, E., Miettunen, J.
• Other Authors: Academy of Finland, Sigrid Jusélius Foundation, Brain & Behavior Research Foundation, Jalmari and Rauha Ahokas Foundation, Finnish Cultural Foundation Lapland Regional Fund, Northern Finland Health Care Support Foundation, scholarship Fund of the University of Oulu - Tyyni Tani Fund, Foundation for Psychiatric Research, Orion Research Foundation sr
• Format: Article in Journal/Newspaper
• Language: English
• Published: Cambridge University Press (CUP) 2017
• Subjects: Northern Finland
• Online Access: http://dx.doi.org/10.1016/j.eurpsy.2017.06.004; https://api.elsevier.com/content/article/PII:S0924933817329061?httpAccept=text/xml; https://api.elsevier.com/content/article/PII:S0924933817329061?httpAccept=text/plain; https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0924933800087575

Abstract Background: Higher lifetime antipsychotic exposure has been associated with poorer cognition in schizophrenia. The cognitive effects of adjunctive psychiatric medications and lifetime trends of antipsychotic use remain largely unclear. We aimed to study how lifetime and current benzodiazepine and antidepressant medications, lifetime trends of antipsychotic use and antipsychotic polypharmacy are associated with cognitive performance in midlife schizophrenia. Methods: Sixty participants with DSM-IV schizophrenia from the Northern Finland Birth Cohort 1966 were examined at 43 years of age with an extensive cognitive test battery. Cumulative lifetime and current use of psychiatric medications were collected from medical records and interviews. The associations between medication and principal component analysis-based cognitive composite score were analysed using linear regression. Results: Lifetime cumulative DDD years of benzodiazepine and antidepressant medications were not significantly associated with global cognition. Being without antipsychotic medication (for minimum 11 months) before the cognitive examination was associated with better cognitive performance ( P = 0.007) and higher lifetime cumulative DDD years of antipsychotics with poorer cognition ( P = 0.020), when adjusted for gender, onset age and lifetime hospital treatment days. Other lifetime trends of antipsychotic use, such as a long antipsychotic-free period earlier in the treatment history, and antipsychotic polypharmacy, were not significantly associated with cognition. Conclusions: 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.