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

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http://hdl.handle.net/10138/298128

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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

Title: Lifetime use of psychiatric medications and cognition at 43 years of age in schizophrenia in the Northern Finland Birth Cohort 1966
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.
Contributor: University of Helsinki, Clinicum
Date: 2017-09
Language: eng
Number of pages: 9
Belongs to series: European Psychiatry
ISSN: 0924-9338
URI: http://hdl.handle.net/10138/298128
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. (C) 2017 Elsevier Masson SAS. All rights reserved.
Subject: 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
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