Cognitive toxicity of pharmacotherapeutic agents used in social anxiety disorder.
OBJECTIVE
To compare cognitive impairment of medications used in social anxiety disorder (SAD).


METHODS
Data from peer-reviewed publications (1975-2007) of controlled, crossover design, pharmacodynamic studies on SAD medications in healthy volunteers were analysed. The number of objective psychometrics for each drug/dose level at all time points after dosing, and of instances of statistically significant impairment of cognitive function, enabled calculation of drug-induced cognitive impairment. The magnitude of impairment between drugs was compared using proportional impairment ratios (PIRs).


RESULTS
Olanzapine, oxazepam, lorazepam and mianserin had twice the average cognitive toxicity of other treatments. Selective serotonin reuptake inhibitors (SSRIs) impaired cognition to a lesser extent than other pharmacological groupings. There was extensive intra-class variation: fluvoxamine (PIR = 0.08) possessed little detrimental cognitive activity, whereas sertraline (PIR = 5.33) caused impairment over five times the SSRI group average. Benzodiazepines caused noticeable cognitive impairment.


CONCLUSIONS
Substantial differences exist, both between and within therapeutic classes, in the behavioural toxicity of medications used for SAD.
Hindmarch
I
I
University of Surrey, Guildford, Surrey, UK. ian@psychopharma.co.uk
D014151:Anti-Anxiety Agents / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000188:drug therapy*; D011596:Psychomotor Disorders / Q000139:chemically induced; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D001569:Benzodiazepines; D017367:Selective Serotonin Reuptake Inhibitors