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Lifetime antipsychotic medication and cognitive performance in schizophrenia at age 43 years in a general population birth cohort

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Husa, AP 
Moilanen, J 
Murray, GK 
Marttila, R 
Haapea, M 


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.



psychosis, cognition, treatment, cross-sectional, adverse effect

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Psychiatry Research

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Medical Research Council (G0701911)
Medical Research Council (G0701911/1)
Funding for this study was provided by the Academy of Finland Grants 132 071, 278 286 and 268 336, the Sigrid Jusélius Foundation, the Brain & Behavior Research Foundation, the Jalmari and Rauha Ahokas Foundation, the Emil Aaltonen Foundation, the Finnish Cultural Foundation Lapland Regional Fund, the Northern Finland Health Care Support Foundation and the UK Medical Research Council Grant G0701911. J.H.B. was an employee of Cambridge Cognition.