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Researchers led by Dr Valentina Mancini and Associate Professor Rob McCutcheon at the Department of Psychiatry at the University of Oxford looked at evidence from 40 studies, with findings published in the American Journal of Psychiatry.
They looked at the data from people who had been prescribed ‘anticholinergic’ medications, which block a chemical in the brain called acetycholine, involved in facilitating the transmission of signals in the brain. These include a wide range of medications including those prescribed to mitigate the side effects of antipsychotic drugs.
They found higher use of these medications correlated with poorer general cognition, verbal and visual learning, memory, attention, executive functioning (e.g. decision making) and slower processing speed.
According to the analysis, tapering off these medicines was linked to improved scores in verbal learning, memory and executive functioning.
Dr Mancini said:
Our findings highlight the negative impact of routinely used medications on cognitive function in people with psychosis. From a clinical perspective, tapering off anticholinergic medication could be beneficial for their cognition, but further research is needed to prove this without question.”
Around 80 per cent of people with psychosis have some form of cognitive impairment, leading to high rates of unemployment and the need for long-term community support.
Anticholinergic properties are found in medications used to treat the side effects of antipsychotics as well as being in some anti-depressants, epilepsy drugs and antihistamines.
Cholinergic neurotransmission is vital for healthy cognitive processing and the current research shows how medicines with anticholinergic properties negatively affect this.
Professor McCutcheon says:
We need to do everything we can to help improve the cognitive health of people with schizophrenia. Improving cognitive health maximises the chance that people can live independent, fulfilling lives. Carefully reviewing the medications patients are prescribed and minimising the use of drugs that have anticholinergic properties is one way we can help.”