An effect of antipsychotic and anticholinergic treatment on cognitive function in patients with schizophrenia

Tumova MA, Stepanova AA, Zazulina YS, et al. . An effect of antipsychotic and anticholinergic treatment on cognitive function in patients with schizophrenia. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(7):80‑85. (In Russ.)
https://doi.org/10.17116/jnevro202312307180

Подписка 2025-2 (S.S. Korsakov Journal of Neurology and Psychiatry)

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OBJECTIVE

To reveal the relationships between antipsychotic and anticholinergic drugs and cognitive functions in patients with schizophrenia.

MATERIAL AND METHODS

The observational prospective study was conducted at the Bekhterev National Medical Center of Psychiatry and Neurology. The study involved 41 patients (22 men and 19 women) with paranoid schizophrenia, according to ICD 10 criteria, aged 30.12±8.24 years on stable antipsychotic monotherapy or in combination with anticholinergic drug (trihexiphenidyl). Cognitive functions were assessed using the «Brief Assessment of Cognitive Function in Patients with Schizophrenia» (BACS) scale, severity of mental state and extrapyramidal disturbances were measured using the «Positive and Negative Syndrome Scale (PANSS) and the Simpson-Angus Scale for Assessment of Extrapyramidal Side Effects (SAS). All examination procedures were performed twice at weeks 2 and 8 of therapy. Patients were divided into 2 groups according to the type of antipsychotic therapy. Twelve patients received first generation antipsychotics (FGAs) (group 1), 29 patients received second generation antipsychotics (SGAs) (group 2).

RESULTS

Patients receiving SGAs had a significant decrease in the overall SAS score at week 8 of therapy compared with data at week 2, and there was an improvement in cognitive function, unlike patients receiving FGAs. There were also changes on BACS tests the digit sequencing (V=51.5, p=0.007), token motor task (V=75.5, p=0.007) and Tower of London (V=52, p=0.027) only in patients of group 2.

CONCLUSION

The improved tolerance to the drug, as well as cognitive measures, was shown in patients taking SGAs by week 8. Our study confirms the importance of adhering to the minimum effective dose of antipsychotic drugs for the treatment of schizophrenia to prevent cognitive impairment, and to give preference to SGAs in the choice of treatment.

Keywords:

cognitive function

BACS

extrapyramidal symptoms

SAS

PANSS

first- and second-generation antipsychotics

Authors:

Tumova M.A.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-3418-8596

Stepanova A.A.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-4029-9401

Zazulina Y.S.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-1962-2147

Guseinova Z.T.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-6737-5486

Zaitseva M.M.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-6055-1037

Dyment I.V.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-7373-3825

Kotsyubinsky A.P.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0002-4826-9688

Ivanov M.V.

Bekhterev National Medical Research Center for Psychiatry and Neurology

ORCID: 0000-0001-5851-0626

Received:

10.02.2023

Accepted:

22.03.2023

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