The longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory

Ballesteros, Alejandro; Sánchez‐Torres, Ana M.; López-Ilundain, Jose M.; Mezquida, Gisela; Lobo, Antonio; González‐Pinto, Ana; Pina‐Camacho, Laura; Corripio, Iluminada; Vieta, Eduard; Serna, Elena de la; Mané, Anna; Bioque, Miquel; Moreno-Izco, Lucía; Espliego, Ana; Lorente-Omeñaca, Ruth; Amoretti, Sílvia; Bernardo, Miguel; Cuesta, Manuel J.

doi:10.1017/s003329172000080x

Cited by 6 publications

(10 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At month 12, no significant difference was observed between high and low anticholinergic burden on verbal memory performance. These results replicate previous longitudinal studies that also failed to find any effect of anticholinergic burden over time, including Ballesteros et al 14 , who did not detect a significant effect of an anticholinergic burden on verbal memory at a two-year follow-up, and Tracy and colleagues 50 , who reported no significant effect of serum anticholinergic levels on verbal memory after one week. However, some longitudinal studies have found that tapering high anticholinergic Anticholinergic Burden and Verbal Memory 16 burden medications (e.g., biperiden) positively impacted cognition, with improved verbal memory.…”

Section: Discussionsupporting

confidence: 88%

“…This finding agrees with several crosssectional studies investigating the association between anticholinergic burden and verbal memory. 5,7,14,17,37,38 However, this association is not maintained after controlling for antipsychotic dosage.…”

Section: Discussionmentioning

confidence: 98%

“…A high anticholinergic burden may be associated with more severe deficits in cognitive functions and, particularly, verbal memory. [14][15][16][17] While cross-sectional studies in FEP suggest an association between anticholinergic burden and verbal memory performance, few studies have examined this longitudinally after initiating medication in FEP patients. Thus, a longitudinal study that includes baseline and follow-up data on cognition and medication would Anticholinergic Burden and Verbal Memory 5 help shed light on this matter.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

Belkacem¹,

Lavigne²,

Makowski³

et al. 2023

Preprint

View full text Add to dashboard Cite

Antipsychotics are widely used to treat first-episode psychosis but may have an anticholinergic burden, i.e., a cumulative effect of medications that block the cholinergic system. Studies suggest that a high anticholinergic burden negatively affects memory in psychosis, where cognitive deficits, particularly those in verbal memory, are a core feature of the disease. The present study sought to replicate this in a large cohort of well-characterized first-episode psychosis patients. We expected that patients in the highest anticholinergic burden group would exhibit the poorest verbal memory compared to those with low anticholinergic burden and to healthy controls at baseline (3 months following admission). We further hypothesized that over time, at month 12, patients' verbal memory performance would improve but would remain inferior to controls. Patients (n=311; low anticholinergic burden [n=241] and high anticholinergic burden [n=70], defined by a Drug Burden Index cut-off of 1) and controls (n=128) completed a clinical and neurocognitive battery including parts of the Wechsler Memory Scale at month 3 and 12. Cross-sectionally, using an ANOVA, patients in the highest anticholinergic burden group had the poorest performance in verbal memory when compared to the other groups at month 3 (F(2,430)=52.33, P<0.001). Longitudinally, using a Generalized Estimating Equation model, the verbal memory performance of all groups improved over time. However, patients' performance overall remained poorer than the controls. These findings highlight the importance of considering the anticholinergic burden when prescribing medications in the early stages of the disease.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

Belkacem¹,

Lavigne²,

Makowski³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…A high anticholinergic burden may be associated with more severe deficits in cognitive functions and, particularly, verbal memory. 14,17 While cross-sectional studies in first-episode psychosis (FEP) suggest an association between anticholinergic burden and verbal memory performance, few studies have examined this longitudinally after initiating medication in FEP patients. Thus, a longitudinal study that includes baseline and follow-up data on cognition and medication would help shed light on this matter.…”

Section: Introductionmentioning

confidence: 99%

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

et al. 2023

View full text Add to dashboard Cite

Objectives Antipsychotics are widely used to treat first-episode psychosis but may have an anticholinergic burden, that is, a cumulative effect of medications that block the cholinergic system. Studies suggest that a high anticholinergic burden negatively affects memory in psychosis, where cognitive deficits, particularly those in verbal memory, are a core feature of the disease. The present study sought to replicate this in a large cohort of well-characterized first-episode psychosis patients. We expected that patients in the highest anticholinergic burden group would exhibit the poorest verbal memory compared to those with low anticholinergic burden and healthy controls at baseline (3 months following admission). We further hypothesized that over time, at month 12, patients’ verbal memory performance would improve but would remain inferior to controls. Methods Patients ( n = 311; low anticholinergic burden [ n = 241] and high anticholinergic burden [ n = 70], defined by a Drug Burden Index cut-off of 1) and healthy controls ( n = 128) completed a clinical and neurocognitive battery including parts of the Wechsler Memory Scale at months 3 and 12. Results Cross-sectionally, using an analysis of variance, patients in the highest anticholinergic burden group had the poorest performance in verbal memory when compared to the other groups at month 3, F(2,430) = 52.33, P < 0.001. Longitudinally, using a Generalized Estimating Equation model, the verbal memory performance of all groups improved over time. However, patients’ performance overall remained poorer than the controls. Conclusion These findings highlight the importance of considering the anticholinergic burden when prescribing medications in the early stages of the disease.

show abstract

“…Ballesteros et al (2020) investigated the relationship between antipsychotic medication dosage, anticholinergic burden and psychosocial functioning in patients with first-episode psychosis over time and whether cognitive deficits, a core feature of the disease, mediated this relationship. Despite important contributions to the existing literature, including a new method of calculating anticholinergic burden, we write to express our concerns and to offer some suggestions regarding the statistical analysis and theoretical framework.…”

mentioning

confidence: 99%

Letter to the editor: the longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory

et al. 2023

View full text Add to dashboard Cite

The longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory

Cited by 6 publications

References 59 publications

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis

Letter to the editor: the longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory

Contact Info

Product

Resources

About