Effects of discontinuation of long-term anticholinergic treatment in elderly schizophrenia patients
KeywordsSchizophrenia Cognitive Functioning Memory Impairment Schizophrenia Patient Assessment Scale
The use of anticholinergic medications (ACM) in psychiatry is mainly for the treatment of D2 blocking agents side-effects. The group most likely to be exposed to ACM are the elderly. However, the ACM themselves are not without adverse effects and in the elderly cognitive and memory impairments have been emphasized. The aim of this study was to evaluate the effects of discontinuation of ACM on cognitive functions in a groupof elderly chronic schizophrenia patients.
Material and Methods
Twenty-seven elderly patients (age 60 years or older) diagnosed as suffering from schizophrenia (DSM-IV) and receiving ACM in addition to antipsychotic treatment were enrolled. Before and after ACM was discontinuation the Alzheimer's disease Assessment Scale – Cognitive subscale (ADAS-Cog) was administered.
Twenty-one patients completed the study. All were receiving biperiden, 2–6 mg daily prior to the study. Significant improvement in the ADAS-Cog total score was demonstrated (p < 0.03) as well as in the ideational praxia and orientation subscales. Improvement was correlated with the dose of biperidin administered. No adverse events or emergent extra-pyramidal symptoms were noted.
Discontinuation of ACM may be warranted in chronic long-stay schizophrenia patients as it may improve cognitive functioning with no adverse effects