Nikolai Albert1, Lasse Randers1, Kelly Allott2,3, Heidi Dorthe Jensen1, Marianne Melau1, Carsten Hjorhøj1, Merete Nordentoft1,4; 1Copenhagen University Hospital, Mental Health Centre Copenhagen, 2Orygen, The National Centre of Excellence in Youth Mental Health, 3Centre for Youth Mental Health, The University of Melbourne, 4University of Copenhagen
Background - The effect of antipsychotics medication on cognitive functioning in patients diagnosed with schizophrenia is poorly understood. Some studies of second-generation antipsychotics indicated that they improved cognitive functioning while other studies have found that they decrease the level of cognitive functioning. Method - We included patients with schizophrenia who were in treatment with antipsychotics 1.5 years (baseline) after initiation of treatment and followed them up 3.5 years later (n=189). At follow-up 60 (32%) had discontinued their antipsychotic treatment and 129 (68%) were still taking antipsychotics. Using the Brief Assessment of Cognition in Schizophrenia (BACS) we assessed cognition at baseline and follow-up. Outcome - The patients who had discontinued their medication had a higher level of cognitive functioning in all domains at baseline, as well as Global cognitive function (mean z-score -1.50 (SD 1.24) vs. -2.27 (SD 1.30), p=.00015). After controlling for relevant confounders those who discontinued antipsychotic medication improved significantly more than those who remained on antipsychotic medication during the course of the follow-up on the Token Motor task, the Speed of Processing Domain and Global cognition. Interpretation - Due to the naturalistic design we cannot conclude on the direction of the relationship between antipsychotic medication and cognition. There is no evidence that discontinuation of medication had a negative effect on cognitive functioning. Rather, we find that that discontinuation of medication was associated with better cognitive functioning
