title: Doubtful association of antipsychotic polypharmacy and high dosage with cognition in chronic schizophrenia.
abstract: Despite consistent recommendations for antipsychotic monotherapy, antipsychotic polypharmacy (the use of two or more antipsychotic agents) and the administration of excessive doses (higher than 1000 mgr/day of chloropromazine equivalents) is a common practice in schizophrenia. The therapeutic and adverse effects of this practice are poorly studied, in particular with regards to the cognitive symptoms of the disease. In this cross-sectional study we investigated the cognitive effects of antipsychotic polypharmacy and excessive doses in 53 patients with chronic schizophrenia using non-verbal cognitive tasks involving speed of movement, memory and executive functions. No significant difference in performance scores was found between the groups under polypharmacy and monotherapy, or the groups receiving either excessive or normal doses of antipsychotics. Since these groups did not also differ in demographic, clinical, other pharmacologic parameters, in the relative anticholinergic potency of antipsychotics, or in intelligence scores, we raise doubts about the association of polypharmacy and excessive doses with non-verbal cognitive performance in chronic schizophrenia.
authors.affiliation: 1st Psychiatric Department, Psychiatric Hospital of Attica, 374, Athinon avenue, 12462, Athens, Greece. dimkontis@gmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kontis
authors.forename: Eirini
authors.initials: E
authors.lastname: Theochari
authors.forename: Spyridon
authors.initials: S
authors.lastname: Kleisas
authors.forename: Stamatina
authors.initials: S
authors.lastname: Kalogerakou
authors.forename: Angeliki
authors.initials: A
authors.lastname: Andreopoulou
authors.forename: Rafael
authors.initials: R
authors.lastname: Psaras
authors.forename: Yannis
authors.initials: Y
authors.lastname: Makris
authors.forename: Charalambos
authors.initials: C
authors.lastname: Karouzos
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Tsaltas
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019338:Polypharmacy; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents