Association of antidepressant and benzodiazepine use, and anticholinergic burden with cognitive performance in schizophrenia

Ville Mäkipelto, Annamari Tuulio-Henriksson, Christian Hakulinen, Solja Niemelä, Markku Lähteenvuo, Asko Wegelius, Tuula Kieseppä, Erkki Isometsä, Jari Tiihonen, Olli Kampman, Kaisla Lahdensuo, Atiqul Mazumder, Jaana Suvisaari, Minna Holm

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Schizophrenia is characterized by cognitive impairment affecting everyday functioning. Earlier research has hypothesized that antidepressants may associate with better cognitive functioning, but results are mixed. This study explored the association between antidepressant use and cognitive performance in terms of reaction time and visual learning in a clinical sample. In addition, we examined benzodiazepine use and anticholinergic burden. Study participants were drawn from the SUPER-Finland cohort, collected among patients with psychotic illnesses in 2016–2018 throughout Finland (n = 10,410). The analysis included adults with a schizophrenia diagnosis (F20) and results from a cognitive assessment (n = 3365). Information about medications and psychosocial factors were gathered through questionnaire and interview. Cognitive performance was assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) with two subtests measuring reaction time and visual learning. Almost 36 % of participants used at least one antidepressant. The use of antidepressants in general was not associated with performance in the reaction time and visual learning tasks. However, the use of SNRI antidepressants was associated with a faster reaction time. Benzodiazepine use and a higher anticholinergic burden were associated with poorer performance in both tests. The results strengthen earlier findings that there is no association between antidepressant use in general and cognitive performance in schizophrenia. However, the association of SNRI medications with a faster reaction time warrants further research. Moreover, the results suggest that more attention should be paid to the anticholinergic burden of the medications used by patients with schizophrenia, as well as avoiding continuous benzodiazepine use.

Original languageEnglish
Pages (from-to)118-126
Number of pages9
JournalSCHIZOPHRENIA RESEARCH
Volume266
DOIs
Publication statusPublished - Apr 2024
Publication typeA1 Journal article-refereed

Keywords

  • Anticholinergic burden
  • Antidepressants
  • Benzodiazepines
  • CANTAB
  • Cognition
  • Cognitive impairment
  • Schizophrenia

Publication forum classification

  • Publication forum level 2

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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