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

Published online by Cambridge University Press:  23 March 2020

A.P. Hulkko ,
G.K. Murray ,
J. Moilanen ,
M. Haapea ,
I. Rannikko ,
P.B. Jones ,
J.H. Barnett ,
S. Huhtaniska ,
M.K. Isohanni  and
H. Koponen
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A.P. Hulkko*
Affiliation:
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000Oulu, Finland, 90014 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O. Box 26Oulu, Finland, 90029 OYS
G.K. Murray
Affiliation:
Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Box 189, CB2 0QQCambridge, United Kingdom Behavioural and Clinical Neuroscience Institute, University of Cambridge, Herchel Smith Building, Forvie Site, Cambridge Biomedical Campus, CB2 0SZCambridge, United Kingdom
J. Moilanen
Affiliation:
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000Oulu, Finland, 90014 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O. Box 26Oulu, Finland, 90029 OYS
M. Haapea
Affiliation:
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50Oulu, Finland, 90029 OYS
I. Rannikko
Affiliation:
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland
P.B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, Herchel Smith Building, CB2 0SZCambridge, United Kingdom
J.H. Barnett
Affiliation:
Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Box 189, CB2 0QQCambridge, United Kingdom Cambridge Cognition Ltd, Tunbridge Court, Bottisham, Cambridge, United Kingdom
S. Huhtaniska
Affiliation:
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000Oulu, Finland, 90014 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland
M.K. Isohanni
Affiliation:
Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland
H. Koponen
Affiliation:
Psychiatry Department, University of Helsinki and Helsinki University Hospital, P.O. Box 22, 00014Helsinki, Finland
E. Jääskeläinen
Affiliation:
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000Oulu, Finland, 90014 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O. Box 26Oulu, Finland, 90029 OYS Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland
J. Miettunen
Affiliation:
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014Oulu, Finland
*
*Corresponding author. Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Fax: +3588336169. E-mail address:[email protected] (A.P. Hulkko).
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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.

Keywords

SchizophreniaCognitionBenzodiazepineAntidepressantAntipsychoticPolypharmacy
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 50 - 58
Copyright
Copyright © European Psychiatric Association 2017

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