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

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 an...

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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., Jaaskelainen, E., Miettunen, J.
Other Authors: Clinicum, Department of Psychiatry, University of Helsinki, HUS Psychiatry
Format: Article in Journal/Newspaper
Language:English
Published: ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER 2019
Subjects:
Schizophrenia
Cognition
Benzodiazepine
Antidepressant
Antipsychotic
Polypharmacy
RANDOMIZED CONTROLLED-TRIALS
TERM BENZODIAZEPINE USE
1ST EPISODE PSYCHOSIS
9-YEAR FOLLOW-UP
ANTIPSYCHOTIC MEDICATION
NEGATIVE SYMPTOMS
LONGITUDINAL MRI
DOSE-REDUCTION
CLINICAL-TRIAL
METAANALYSIS
3124 Neurology and psychiatry
Northern Finland
Online Access:http://hdl.handle.net/10138/298128
id ftunivhelsihelda:oai:helda.helsinki.fi:10138/298128
record_format openpolar
institution Open Polar
collection HELDA – University of Helsinki Open Repository
op_collection_id ftunivhelsihelda
language English
topic Schizophrenia
Cognition
Benzodiazepine
Antidepressant
Antipsychotic
Polypharmacy
RANDOMIZED CONTROLLED-TRIALS
TERM BENZODIAZEPINE USE
1ST EPISODE PSYCHOSIS
9-YEAR FOLLOW-UP
ANTIPSYCHOTIC MEDICATION
NEGATIVE SYMPTOMS
LONGITUDINAL MRI
DOSE-REDUCTION
CLINICAL-TRIAL
METAANALYSIS
3124 Neurology and psychiatry
spellingShingle Schizophrenia
Cognition
Benzodiazepine
Antidepressant
Antipsychotic
Polypharmacy
RANDOMIZED CONTROLLED-TRIALS
TERM BENZODIAZEPINE USE
1ST EPISODE PSYCHOSIS
9-YEAR FOLLOW-UP
ANTIPSYCHOTIC MEDICATION
NEGATIVE SYMPTOMS
LONGITUDINAL MRI
DOSE-REDUCTION
CLINICAL-TRIAL
METAANALYSIS
3124 Neurology and psychiatry
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.
Jaaskelainen, E.
Miettunen, J.
Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
topic_facet Schizophrenia
Cognition
Benzodiazepine
Antidepressant
Antipsychotic
Polypharmacy
RANDOMIZED CONTROLLED-TRIALS
TERM BENZODIAZEPINE USE
1ST EPISODE PSYCHOSIS
9-YEAR FOLLOW-UP
ANTIPSYCHOTIC MEDICATION
NEGATIVE SYMPTOMS
LONGITUDINAL MRI
DOSE-REDUCTION
CLINICAL-TRIAL
METAANALYSIS
3124 Neurology and psychiatry
description 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. (C) 2017 Elsevier Masson SAS. All rights reserved. Peer reviewed
author2 Clinicum
Department of Psychiatry
University of Helsinki
HUS Psychiatry
format Article in Journal/Newspaper
author 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.
Jaaskelainen, E.
Miettunen, J.
author_facet 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.
Jaaskelainen, E.
Miettunen, J.
author_sort Hulkko, A. P.
title Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
title_short Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
title_full Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
title_fullStr Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
title_full_unstemmed Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
title_sort lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the northern finland birth cohort 1966
publisher ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
publishDate 2019
url http://hdl.handle.net/10138/298128
genre Northern Finland
genre_facet Northern Finland
op_relation 10.1016/j.eurpsy.2017.06.004
This work was supported by the Academy of Finland [grant numbers 278 286, 268 336], the Sigrid Juselius Foundation, the Brain & Behavior Research Foundation, the Jalmari and Rauha Ahokas Foundation, the Finnish Cultural Foundation Lapland Regional Fund, the Northern Finland Health Care Support Foundation, the scholarship Fund of the University of Oulu - Tyyni Tani Fund, the Foundation for Psychiatric Research and the Orion Research Foundation sr. J.H.B. was an employee of Cambridge Cognition. The funding bodies had no further role in study design; in the collection, management, analysis and interpretation of data; in the preparation, review or approval of the manuscript; or in the decision to submit the paper for publication.
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 , Jaaskelainen , E & Miettunen , J 2017 , ' Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966 ' , European Psychiatry , vol. 45 , pp. 50-58 . https://doi.org/10.1016/j.eurpsy.2017.06.004
ORCID: /0000-0002-7368-1869/work/39205493
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http://hdl.handle.net/10138/298128
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op_rights openAccess
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container_title European Psychiatry
container_volume 45
container_start_page 50
op_container_end_page 58
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spelling ftunivhelsihelda:oai:helda.helsinki.fi:10138/298128 2024-01-07T09:45:27+01:00 Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966 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. Jaaskelainen, E. Miettunen, J. Clinicum Department of Psychiatry University of Helsinki HUS Psychiatry 2019-01-23T22:39:06Z 9 application/pdf http://hdl.handle.net/10138/298128 eng eng ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER 10.1016/j.eurpsy.2017.06.004 This work was supported by the Academy of Finland [grant numbers 278 286, 268 336], the Sigrid Juselius Foundation, the Brain & Behavior Research Foundation, the Jalmari and Rauha Ahokas Foundation, the Finnish Cultural Foundation Lapland Regional Fund, the Northern Finland Health Care Support Foundation, the scholarship Fund of the University of Oulu - Tyyni Tani Fund, the Foundation for Psychiatric Research and the Orion Research Foundation sr. J.H.B. was an employee of Cambridge Cognition. The funding bodies had no further role in study design; in the collection, management, analysis and interpretation of data; in the preparation, review or approval of the manuscript; or in the decision to submit the paper for publication. 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 , Jaaskelainen , E & Miettunen , J 2017 , ' Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966 ' , European Psychiatry , vol. 45 , pp. 50-58 . https://doi.org/10.1016/j.eurpsy.2017.06.004 ORCID: /0000-0002-7368-1869/work/39205493 85024486540 109d99e2-8530-416f-80ed-fd6e71d86d7d http://hdl.handle.net/10138/298128 000414461300008 openAccess info:eu-repo/semantics/openAccess Schizophrenia Cognition Benzodiazepine Antidepressant Antipsychotic Polypharmacy RANDOMIZED CONTROLLED-TRIALS TERM BENZODIAZEPINE USE 1ST EPISODE PSYCHOSIS 9-YEAR FOLLOW-UP ANTIPSYCHOTIC MEDICATION NEGATIVE SYMPTOMS LONGITUDINAL MRI DOSE-REDUCTION CLINICAL-TRIAL METAANALYSIS 3124 Neurology and psychiatry Article publishedVersion 2019 ftunivhelsihelda 2023-12-14T00:02:15Z 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. (C) 2017 Elsevier Masson SAS. All rights reserved. Peer reviewed Article in Journal/Newspaper Northern Finland HELDA – University of Helsinki Open Repository European Psychiatry 45 50 58

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