Anticholinergic Medication Burden–Associated Cognitive Impairment in Schizophrenia
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Clinical Assessments
Characteristic | ||
---|---|---|
Mean | SD | |
Age (years) | 46.2 | 11.0 |
Age at onset (years) | 22.3 | 6.9 |
Duration of illness (years) | 23.8 | 11.4 |
Education (years) | 12.5 | 2.1 |
Number of past hospitalizations | 7.3 | 9.7 |
Global Assessment of Functioning score | 43.8 | 8.2 |
Scale for the Assessment of Positive Symptoms score | 6.9 | 4.0 |
Scale for the Assessment of Negative Symptoms score | 11.0 | 5.8 |
Antipsychotic dosage (chlorpromazine equivalents, mg/day) | 457 | 538 |
Cigarettes per day | 7.8 | 10.0 |
N | % | |
Female | 351 | 31.3 |
Hispanic ethnicity | 161 | 14.4 |
Race | ||
Native American | 7 | 0.6 |
Asian | 34 | 3.0 |
Pacific Islander | 11 | 1.0 |
African American | 442 | 39.5 |
Caucasian | 483 | 43.1 |
More than one race | 137 | 12.2 |
Not reported | 6 | 0.5 |
Medication | ||
Antipsychotics | ||
None | 113 | 10.1 |
One antipsychotic | 783 | 69.9 |
Second-generation | 708 | 90.4 |
First-generation | 75 | 9.6 |
Two antipsychotics | 198 | 17.7 |
Three antipsychotics | 26 | 2.3 |
Anticholinergics | ||
One anticholinergic | 225 | 20.1 |
Benztropine | 147 | 65.3 |
Diphenhydramine | 32 | 14.2 |
Hydroxyzine | 28 | 12.4 |
Trihexyphenidyl | 18 | 8 |
Two anticholinergics | 20 | 1.8 |
Antidepressants | ||
One antidepressant | 418 | 37.3 |
Two antidepressants | 80 | 7.1 |
Three antidepressants | 5 | 0.4 |
Mood stabilizers | ||
One mood stabilizer | 224 | 20 |
Two mood stabilizers | 15 | 1.3 |
Three mood stabilizers | 2 | 0.2 |
Benzodiazepines | ||
One benzodiazepine | 167 | 14.9 |
Two benzodiazepines | 14 | 1.3 |
Assessment of Anticholinergic Burden
Cognitive Assessments
Statistical Analysis
Results
Magnitude and Sources of Anticholinergic Burden in Schizophrenia Patients
![](/cms/10.1176/appi.ajp.2020.20081212/asset/images/large/appi.ajp.2020.20081212f1.jpeg)
![](/cms/10.1176/appi.ajp.2020.20081212/asset/images/large/appi.ajp.2020.20081212f2.jpeg)
Association of Anticholinergic Medication Burden With Cognitive Functioning
![](/cms/10.1176/appi.ajp.2020.20081212/asset/images/large/appi.ajp.2020.20081212f3.jpeg)
Specificity of ACB Score Effects on Cognitive Domains
![](/cms/10.1176/appi.ajp.2020.20081212/asset/images/large/appi.ajp.2020.20081212f4.jpeg)
Discussion
Limitations
Recommendations
Acknowledgments
Footnotes
Supplementary Material
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