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Vidal N, Roux P, Urbach M, Belmonte C, Boyer L, Capdevielle D, Clauss-Kobayashi J, D’Amato T, Dassing R, Dubertret C, Dubreucq J, Fond G, Honciuc RM, Leignier S, Llorca PM, Mallet J, Misdrahi D, Pignon B, Rey R, Schürhoff F, Tessier A, Passerieux C, Brunet-Gouet E. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort. Front Pharmacol 2024; 15:1403093. [PMID: 38933674 PMCID: PMC11200119 DOI: 10.3389/fphar.2024.1403093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024] Open
Abstract
Aim The anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia. Methods We identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance. Results Eight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = -0.12, p = .004) and reasoning (Standardized β = -0.08, p = .037). Conclusion Anticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.
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Affiliation(s)
- Nathan Vidal
- FondaMental Foundation, Créteil, France
- Centre Hospitalier de Versailles, Service universitaire de psychiatrie d’adultes et d’addictologie, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
| | - Paul Roux
- FondaMental Foundation, Créteil, France
- Centre Hospitalier de Versailles, Service universitaire de psychiatrie d’adultes et d’addictologie, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
| | - Mathieu Urbach
- FondaMental Foundation, Créteil, France
- Centre Hospitalier de Versailles, Service universitaire de psychiatrie d’adultes et d’addictologie, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
| | - Cristobal Belmonte
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
| | - Laurent Boyer
- FondaMental Foundation, Créteil, France
- EA 3279: Department of Epidemiology and Health Economics, School of Medicine—La Timone Medical Campus, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Delphine Capdevielle
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
| | - Julie Clauss-Kobayashi
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospitals of Strasbourg, University of Strasbourg, Institut National de la Santé et de la Recherche Médicale (INSERM), Strasbourg, France
| | - Thierry D’Amato
- FondaMental Foundation, Créteil, France
- Le Vinatier Hospital, Schizophrenia Expert Centre, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), University Lyon 1, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France
| | - Romane Dassing
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospitals of Strasbourg, University of Strasbourg, Institut National de la Santé et de la Recherche Médicale (INSERM), Strasbourg, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil, France
- Assistance Publique—Hôpitaux de Paris (AP-HP), Department of Psychiatry, Louis Mourier Hospital, Institut National de la Santé et de la Recherche Médicale (INSERM), Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Julien Dubreucq
- FondaMental Foundation, Créteil, France
- Grenoble Alpes University, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble Alpes, Grenoble Institute of Neurosciences, Grenoble, France
| | - Guillaume Fond
- FondaMental Foundation, Créteil, France
- EA 3279: Department of Epidemiology and Health Economics, School of Medicine—La Timone Medical Campus, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Roxana-Mihaela Honciuc
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service of psychiatry B, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Sylvain Leignier
- FondaMental Foundation, Créteil, France
- Grenoble Alpes University, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble Alpes, Grenoble Institute of Neurosciences, Grenoble, France
| | - Pierre-Michel Llorca
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service of psychiatry B, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Jasmina Mallet
- FondaMental Foundation, Créteil, France
- Assistance Publique—Hôpitaux de Paris (AP-HP), Department of Psychiatry, Louis Mourier Hospital, Institut National de la Santé et de la Recherche Médicale (INSERM), Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - David Misdrahi
- FondaMental Foundation, Créteil, France
- Department of Universitary and General Psychiatry, Charles Perrens Hospital, University of Bordeaux, Aquitaine Institute for Cognitive and Integrative Neuroscience (CNRS UMR 5287-INCIA, ECOPSY), Bordeaux, France
| | - Baptiste Pignon
- FondaMental Foundation, Créteil, France
- Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires “H. Mondor”, DMU IMPACT, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Médicale (IMRB), Translational Neuropsychiatry, University Paris-Est-Créteil (UPEC), Créteil, France
| | - Romain Rey
- FondaMental Foundation, Créteil, France
- Le Vinatier Hospital, Schizophrenia Expert Centre, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), University Lyon 1, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France
| | - Franck Schürhoff
- FondaMental Foundation, Créteil, France
- Assistance Publique—Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires “H. Mondor”, DMU IMPACT, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Médicale (IMRB), Translational Neuropsychiatry, University Paris-Est-Créteil (UPEC), Créteil, France
| | - Arnaud Tessier
- FondaMental Foundation, Créteil, France
- Department of Universitary and General Psychiatry, Charles Perrens Hospital, University of Bordeaux, Aquitaine Institute for Cognitive and Integrative Neuroscience (CNRS UMR 5287-INCIA, ECOPSY), Bordeaux, France
| | - Christine Passerieux
- FondaMental Foundation, Créteil, France
- Centre Hospitalier de Versailles, Service universitaire de psychiatrie d’adultes et d’addictologie, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
| | - Eric Brunet-Gouet
- FondaMental Foundation, Créteil, France
- Centre Hospitalier de Versailles, Service universitaire de psychiatrie d’adultes et d’addictologie, Le Chesnay, Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France
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2
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Mäkipelto V, Tuulio-Henriksson A, Hakulinen C, Niemelä S, Lähteenvuo M, Wegelius A, Kieseppä T, Isometsä E, Tiihonen J, Kampman O, Lahdensuo K, Mazumder A, Suvisaari J, Holm M. Association of antidepressant and benzodiazepine use, and anticholinergic burden with cognitive performance in schizophrenia. Schizophr Res 2024; 266:118-126. [PMID: 38401410 DOI: 10.1016/j.schres.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 12/01/2023] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
Schizophrenia is characterized by cognitive impairment affecting everyday functioning. Earlier research has hypothesized that antidepressants may associate with better cognitive functioning, but results are mixed. This study explored the association between antidepressant use and cognitive performance in terms of reaction time and visual learning in a clinical sample. In addition, we examined benzodiazepine use and anticholinergic burden. Study participants were drawn from the SUPER-Finland cohort, collected among patients with psychotic illnesses in 2016-2018 throughout Finland (n = 10,410). The analysis included adults with a schizophrenia diagnosis (F20) and results from a cognitive assessment (n = 3365). Information about medications and psychosocial factors were gathered through questionnaire and interview. Cognitive performance was assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) with two subtests measuring reaction time and visual learning. Almost 36 % of participants used at least one antidepressant. The use of antidepressants in general was not associated with performance in the reaction time and visual learning tasks. However, the use of SNRI antidepressants was associated with a faster reaction time. Benzodiazepine use and a higher anticholinergic burden were associated with poorer performance in both tests. The results strengthen earlier findings that there is no association between antidepressant use in general and cognitive performance in schizophrenia. However, the association of SNRI medications with a faster reaction time warrants further research. Moreover, the results suggest that more attention should be paid to the anticholinergic burden of the medications used by patients with schizophrenia, as well as avoiding continuous benzodiazepine use.
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Affiliation(s)
- Ville Mäkipelto
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | | | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
| | - Asko Wegelius
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki, Finland
| | - Tuula Kieseppä
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki, Finland
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Olli Kampman
- Department of Psychiatry, University of Turku, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; The Pirkanmaa Wellbeing Services County, Department of Psychiatry, Tampere, Finland; Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden; The Wellbeing Services County of Ostrobothnia, Department of Psychiatry, Finland
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Finland; Mehiläinen, Helsinki, Finland
| | - Atiqul Mazumder
- Department of Psychiatry, University of Turku, Finland; Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Minna Holm
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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3
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Kline CL, Suzuki T, Simmonite M, Taylor SF. Catatonia is associated with higher rates of negative affect amongst patients with schizophrenia and schizoaffective disorder. Schizophr Res 2024; 263:208-213. [PMID: 36114099 DOI: 10.1016/j.schres.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/19/2022]
Abstract
Catatonia is a complex syndrome encompassing motor, behavioral, and affective symptoms seen in a significant proportion of patients with schizophrenia. There is growing evidence to suggest affective dysregulation is a salient feature of both catatonia and schizophrenia. To test the hypothesis of a linkage between affective dysregulation and catatonia in schizophrenia, we searched electronic medical records from 36,839 patients with schizophrenia, using anxiety and depression diagnoses as proxies for affective dysregulation. Catatonia was found in 4.7 % of the cohort. Analyses indicated that catatonia was significantly associated with both anxiety and depression co-morbidities: schizophrenia patients with catatonia were 1.71 times more likely to have anxiety and 1.80 times more likely to have depression than those without catatonia. Benzodiazepine usage was also 7.73 times more common in schizophrenia patients with a catatonia diagnosis than without that diagnosis. Taken together, the findings could be related to GABAergic dysfunction underlying schizophrenia, catatonia, and affective dysregulation.
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Affiliation(s)
- Christopher L Kline
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Takakuni Suzuki
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Molly Simmonite
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
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4
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Vidal N, Brunet-Gouet E, Frileux S, Aouizerate B, Aubin V, Belzeaux R, Courtet P, D'Amato T, Dubertret C, Etain B, Haffen E, Januel D, Leboyer M, Lefrere A, Llorca PM, Marlinge E, Olié E, Polosan M, Schwan R, Walter M, Passerieux C, Roux P. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment and self-reported side effects in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort. Eur Neuropsychopharmacol 2023; 77:67-79. [PMID: 37741163 DOI: 10.1016/j.euroneuro.2023.08.502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/25/2023]
Abstract
Bipolar disorders (BD) are characterized by cognitive impairment during the euthymic phase, to which treatments can contribute. The anticholinergic properties of medications, i.e., the ability of a treatment to inhibit cholinergic receptors, are associated with cognitive impairment in elderly patients and people with schizophrenia but this association has not been well characterized in individuals with remitted BD. Moreover, the validity of only one anticholinergic burden scale designed to assess the anticholinergic load of medications has been tested in BD. In a literature review, we identified 31 existing scales. We first measured the associations between 27 out of the 31 scales and objective cognitive impairment in bivariable regressions. We then adjusted the bivariable models with covariates: the scales significantly associated with cognitive impairment in bivariable and multiple logistic regressions were defined as having good concurrent validity to assess cognitive impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a neuropsychological battery, two scales had good concurrent validity to assess cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents, the number of antipsychotics, or the number of treatments had not. Finally, similar analyses with subjective anticholinergic side-effects as outcome variables reported 14 scales with good concurrent validity to assess self-reported peripheral anticholinergic side-effects and 13 to assess self-reported central anticholinergic side-effects. Thus, we identified valid scales to monitor the anticholinergic burden in BD, which may be useful in estimating iatrogenic cognitive impairment in studies investigating cognition in BD.
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Affiliation(s)
- N Vidal
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France.
| | - E Brunet-Gouet
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - S Frileux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - V Aubin
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - R Belzeaux
- Fondation FondaMental, Créteil, France; Pôle universitaire de psychiatrie, CHU de Montpellier, Montpellier, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P Courtet
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; University Lyon 1, Villeurbanne; INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: From Resistance to Response Team, Lyon, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France, Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - B Etain
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Haffen
- Fondation FondaMental, Créteil, France; Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - D Januel
- Fondation FondaMental, Créteil, France; Unité de Recherche Clinique, EPS Ville-Evrard, 93332 Neuilly-sur-Marne, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory,; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - A Lefrere
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; Centre Hospitalier et Universitaire, Département de Psychiatrie, Université d'Auvergne, EA 7280, Clermont-Ferrand, France
| | - E Marlinge
- Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Olié
- Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie, Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - M Polosan
- Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - R Schwan
- Fondation FondaMental, Créteil, France; Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - M Walter
- Fondation FondaMental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
| | - P Roux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay; Université Paris-Saclay, Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif, France
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Eum S, Hill SK, Bishop JR. Considering medication exposure in genomic association studies of cognition in psychotic disorders. Pharmacogenomics 2022; 23:791-806. [PMID: 36102182 DOI: 10.2217/pgs-2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cognitive dysfunction is a core feature of psychosis-spectrum illnesses, and the characterization of related genetic mechanisms may provide insights regarding the disease pathophysiology. Substantial efforts have been made to determine the genetic component of cognitive symptoms, without clear success. Illness-related moderators and environmental factors such as medications hinder the detection of genomic association with cognition. Polypharmacy is common in psychotic disorders, and the cumulative effects of medication regimens can confound gene-cognition associations. A review of the relative contributions of important pharmacological and genetic relationships identifies that the effects of medications on cognition in psychotic disorders may be at least, if not more, impactful than individual genes, thus underscoring the importance of accounting for medication exposure in gene-cognition association studies.
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Affiliation(s)
- Seenae Eum
- Department of Pharmacogenomics, School of Pharmacy, Shenandoah University, Fairfax, VA 22031, USA
| | - Scot Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Jeffrey R Bishop
- Department of Experimental & Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.,Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA
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