Is cognitive impairment associated with antipsychotic dose and anticholinergic equivalent loads in first-episode psychosis?

Alejandro Ballesteros, Ana M. Sánchez-Torres, Jose M. López-Ilundain, Bibiana Cabrera, Antonio Lobo, Ana M. González-Pinto, Covadonga Díaz-Caneja, Iluminada Corripio, Eduard Vieta, Elena De La Serna, Julio Bobes, Judith Usall, Fernando Contreras, Ruth Lorente-Omeñaca, Gisela Mezquida, Miguel Bernardo, Manuel J. Cuesta, Miquel Bioque, Silvia Amoretti, Mara ParelladaRaquel Vicente, Anna Alonso, Mireia Rabella, Itxaso Gonzalez-Ortega, Patricia Vega, Julio Arbej, Nicolas Fayed, Julio Sanjuan, Esther Lorente-Rovira, Daniel Berge, Antoni Bulbena, Diego Hidalgo-Mazzei, Marina Garriga, Immaculada Baeza, Josefina Castro-Fornieles, Auria Albacete, Jose Manuel Menchon, Mapaz P. Garcia-Portilla, Leticia Garciaalvarez, Miguel Gutierrrez, Aranzazu Zabala, Roberto Rodriguez-Jimenez, Isabel Morales-Munoz, Anna Butjosa, Marta Pardo-Gallego, Salvador Sarro, Ramon Landin-Moreno, Angela Ibanez, Lucia Moreno-Izco, Vicente Balanza-Martinez

Research output: Contribution to journalArticleResearch

21 Citations (Scopus)


Copyright © Cambridge University Press 2018. Background Cognitive deficits are a core feature of early stages in schizophrenia. However, the extent to which antipsychotic (AP) have a deleterious effect on cognitive performance remains under debate. We aim to investigate whether anticholinergic loadings and dose of AP drugs in first episode of psychosis (FEP) in advanced phase of remission are associated with cognitive impairment and the differences between premorbid intellectual quotient (IQ) subgroups.Methods Two hundred and sixty-six patients participated. The primary outcomes were cognitive dimensions, dopaminergic/anticholinergic load of AP [in chlorpromazine equivalents (Eq-CPZ) and the Anticholinergic Risk Scale (ARS), respectively].Results Impairments in processing speed, verbal memory and global cognition were significantly associated with high Eq-CPZ and verbal impairment with high ARS score. Moreover, this effect was higher in the low IQ subgroup.Conclusions Clinicians should be aware of the potential cognitive impairment associated with AP in advanced remission FEP, particularly in lower premorbid IQ patients.
Original languageEnglish
Pages (from-to)2247-2256
JournalPsychological Medicine
Publication statusPublished - 1 Oct 2018


  • Anticholinergic
  • antipsychotics
  • cognition
  • first episode psychosis
  • premorbid intellectual quotient.


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