Lifetime antipsychotic medication and cognitive performance in schizophrenia at age 43 years in a general population birth cohort. (January 2017)

• Record Type: Journal Article
• Authors: Husa, Anja P.; Moilanen, Jani; Murray, Graham K.; Marttila, Riikka; Haapea, Marianne; Rannikko, Irina; Barnett, Jennifer H.; Jones, Peter B.; Isohanni, Matti; Remes, Anne M.; Koponen, Hannu; Miettunen, Jouko; Jääskeläinen, Erika
• Is Part Of: Psychiatry research. Volume 247(2017)
• Page Start: 130
• Page End: 138
• Publication Date: 2017-01
• Subjects: Psychosis -- Cognition -- Treatment -- Cross-sectional -- Adverse effect; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2016.10.085
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: This naturalistic study analysed the association between cumulative lifetime antipsychotic dose and cognition in schizophrenia after an average of 16.5 years of illness. Sixty participants with schizophrenia and 191 controls from the Northern Finland Birth Cohort 1966 were assessed at age 43 years with a neurocognitive test battery. Cumulative lifetime antipsychotic dose-years were collected from medical records and interviews. The association between antipsychotic dose-years and a cognitive composite score based on principal component analysis was analysed using linear regression. Higher lifetime antipsychotic dose-years were significantly associated with poorer cognitive composite score, when adjusted for gender, onset age and lifetime hospital treatment days. The effects of typical and atypical antipsychotics did not differ. This is the first report of an association between cumulative lifetime antipsychotic dose and global cognition in midlife schizophrenia. Based on these data, higher lifetime antipsychotic dose-years may be associated with poorer cognitive performance at age 43 years. Potential biases related to the naturalistic design may partly explain the results; nonetheless, it is possible that large antipsychotic doses harm cognition in schizophrenia in the long-term. Highlights: Higher antipsychotic exposure related to poorer cognition in midlife schizophrenia. Potential biases related to this naturalistic design may contribute to the effects. Higher antipsychotic doses may negatively affect cognitive course in schizophrenia. Preventing or attenuating cognitive recovery may be an explanation for the results.