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...
Published in: | European Psychiatry |
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Language: | English |
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ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
2019
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Online Access: | http://hdl.handle.net/10138/298128 |
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ftunivhelsihelda:oai:helda.helsinki.fi:10138/298128 |
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Open Polar |
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HELDA – University of Helsinki Open Repository |
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ftunivhelsihelda |
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English |
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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 85024486540 109d99e2-8530-416f-80ed-fd6e71d86d7d http://hdl.handle.net/10138/298128 000414461300008 |
op_rights |
openAccess info:eu-repo/semantics/openAccess |
container_title |
European Psychiatry |
container_volume |
45 |
container_start_page |
50 |
op_container_end_page |
58 |
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1787426986467000320 |
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 |