Magazine article Clinical Psychiatry News

Benzodiazepines and Antidepressants Do Not Impair Cognition in Midlife Schizophrenia

Magazine article Clinical Psychiatry News

Benzodiazepines and Antidepressants Do Not Impair Cognition in Midlife Schizophrenia

Article excerpt

PARIS--Cumulative lifetime exposure to benzodiazepines and antidepressants in the relatively modest amounts typically prescribed in schizophrenia did not appear to adversely affect patients' cognition in midlife, according to a first-of-its-kind study from Finland.

"These findings are reassuring," said Anja P. Hulkko, MD, a psychiatric resident at the University of Oulu (Finland).

"The finding regarding antidepressants is especially important because, in the long-term treatment of schizophrenia, it's often the case that patients develop depressive symptoms and they are often underevaluated and undertreated. Our results show you can feel safe in treating them with antidepressant drugs," she said in an interview.

"Similarly, you don't need to worry about using benzodiazepines in schizophrenia if you are using small doses or for short periods to treat a specific condition like anxiety or sleeplessness," Dr. Hulkko said at the annual congress of the European College of Neuropsychopharmacology.

These observations were among the key findings of her analysis from the Northern Finnish Birth Cohort 1966. This ongoing unique and naturalistic observational study--or actually, more than 20 different studies conducted in the same population--was designed to study risk factors involved in preterm birth and intrauterine growth retardation, as well as the consequences of these early adverse events on later morbidity and mortality. Data, including maternal health during pregnancy, have been prospectively collected from first prenatal contact at weeks 10-16 well into adulthood.

The 1966 cohort included 12,058 live births in the two northernmost provinces of Finland, which was 96% of all births there in that year. DNA samples were obtained from nearly 6,000 subjects in the cohort. After birth and again every 7-15 years, the offspring were examined and underwent clinical evaluation in which a wide range of phenotypic, behavioral, and demographic data were collected. Linkage to Finland's comprehensive national registries provides investigators with up-to-date information about participants' education, medication, hospitalizations, significant medical diagnoses, pensions, and death. These prospective data allow investigations of the importance of genetic, biologic, social, and behavioral risk factors in the emergence of various target diseases, one of which is schizophrenia.

Dr. Hulkko's presentation focused on 60 patients with various schizophrenia spectrum disorders who underwent an extensive battery of neuropsychological tests at age 43, when they averaged 16.5 years of illness.

Lifetime cumulative exposure to benzodiazepines or antidepressants was not significantly associated with a global composite cognition score in a multivariate analysis adjusted for potential confounders, including sex, age at schizophrenia onset, and lifetime psychiatric hospital treatment days. …

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