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Is cognitive impairment associated with antipsychotic dose and anticholinergic equivalent loads in first-episode psychosis?

  • Alejandro Ballesteros (a1) (a2), Ana M. Sánchez-Torres (a2) (a3), Jose M. López-Ilundain (a2) (a3), Bibiana Cabrera (a4) (a5), Antonio Lobo (a6), Ana M. González-Pinto (a5) (a7) (a8), Covadonga Díaz-Caneja (a5) (a9), Iluminada Corripio (a5) (a10), Eduard Vieta (a5) (a11) (a12) (a13) (a14), Elena de la Serna (a5) (a15), Julio Bobes (a5) (a16) (a17), Judith Usall (a5) (a18), Fernando Contreras (a5) (a19) (a20), Ruth Lorente-Omeñaca (a2) (a3), Gisela Mezquida (a4) (a5), Miguel Bernardo (a4) (a5) (a14), Manuel J. Cuesta (a2) (a3) and PEPs Group (a4) (a5) (a7) (a8) (a9) (a10) (a21) (a22) (a23) (a24) (a25) (a26) (a27) (a28) (a29) (a30) (a31) (a32) (a33) (a34) (a35) (a36) (a37)...

Abstract

Background

Cognitive deficits are a core feature of early stages in schizophrenia. However, the extent to which antipsychotic (AP) have a deleterious effect on cognitive performance remains under debate. We aim to investigate whether anticholinergic loadings and dose of AP drugs in first episode of psychosis (FEP) in advanced phase of remission are associated with cognitive impairment and the differences between premorbid intellectual quotient (IQ) subgroups.

Methods

Two hundred and sixty-six patients participated. The primary outcomes were cognitive dimensions, dopaminergic/anticholinergic load of AP [in chlorpromazine equivalents (Eq-CPZ) and the Anticholinergic Risk Scale (ARS), respectively].

Results

Impairments in processing speed, verbal memory and global cognition were significantly associated with high Eq-CPZ and verbal impairment with high ARS score. Moreover, this effect was higher in the low IQ subgroup.

Conclusions

Clinicians should be aware of the potential cognitive impairment associated with AP in advanced remission FEP, particularly in lower premorbid IQ patients.

Copyright

Corresponding author

Author for correspondence: Manuel J. Cuesta, E-mail: mcuestaz@cfnavarra.es

Footnotes

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The authors of the PEPs Group who participated in this manuscript are: Miquel Bioque4,5, Silvia Amoretti4,5, Mara Parellada5,9, Raquel Vicente5,21, Anna Alonso5,10, Mireia Rabella5,10, Itxaso González-Ortega5,7,8, Patricia Vega5,7,8, Julio Arbej22, Nicolás Fayed23, Julio Sanjuan5,24, Esther Lorente-Rovira5,24, Daniel Bergé5,25, Antoni Bulbena5,25, Diego Hidalgo-Mazzei5,11,12,13, Marina Garriga5,11,12,13, Immaculada Baeza5,15, Josefina Castro-Fornieles5,15, Àuria Albacete5,19,20, Jose Manuel Menchón5,19,20, Mª Paz García-Portilla5,16,17, Leticia García-Álvarez5,16,17, Miguel Gutiérrrez5,7, Aranzazu Zabala5,26, Roberto Rodriguez-Jimenez5,27, Isabel Morales-Muñoz27, Anna Butjosa5,18,28,29, Marta Pardo-Gallego30, Salvador Sarró5,31, Ramón Landín-Moreno32,33,34, Ángela Ibáñez5,35, Lucía Moreno-Izco2,3 and Vicente Balanzá-Martínez5,36,37.

Footnotes

References

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