title: Are psychotropic medications associated with differences in baseline neurocognitive assessment scores for young athletes? A pilot study.
abstract: OBJECTIVE
  Baseline and post-concussive neurocognitive testing is useful in managing concussed athletes. The Concussion in Sport Group has postulated that the use of psychotropic medications is a modifying factor in the management of sport-related concussion. About 7% of US adolescents are prescribed psychotropics in a given year. Our aim was to investigate whether psychotropic medication use or psychiatric illness is associated with differences in baseline neurocognitive test scores.
  
  
  METHODS
  From 2007 to 2012, over 7000 athletes underwent pre-participation baseline neurocognitive testing using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. Following application of inclusion and exclusion criteria, athletes' self-reported medication lists were reviewed and: 1) classified as psychotropic or not and 2) subclassified. Group subclassification yielded: 1) use of any psychotropic medication, 2) psychostimulant use, 3) antidepressant use and 4) self-reported history of depression and/or anxiety without psychotropic use. Each group was matched, by sex, age, body mass index, education level and concussion history with athletes who were not reportedly prescribed psychotropic medications or did not report a depression/anxiety history, respectively. Each group's baseline ImPACT scores were compared to matched controls.
  
  
  RESULTS
  The use of prescribed psychotropic medications without regard to subclass had no effect on baseline ImPACT composite scores among athletes ages 13-25. However, athletes reportedly prescribed psychostimulants displayed significantly lower visual motor speed scores (32.8 vs 37.1, p = 0.030) and slower reaction times (0.65 vs 0.60, p = 0.044) than non-users. In contrast, antidepressant users displayed significantly faster reaction times (0.58 vs 0.61, p = 0.029). Those reporting a history of depression/anxiety, not treated with psychotropics, displayed significantly lower visual memory (70.4 vs 75.2, p = 0.010) and higher symptom scores (8.83 vs 4.72, p = 0.005).
  
  
  CONCLUSIONS
  This pilot study suggests that self-reported psychotropic medications are associated with differences in baseline ImPACT test scores, which appear dependent on medication subclass. Our preliminary results support the inclusion of psychotropic medications, specifically psychostimulants and antidepressants, as well as history of depression/anxiety as potential concussion modifiers.
authors.affiliation: a 1 Vanderbilt University School of Medicine - Vanderbilt Sports Concussion Center , Nashville, TN, USA.
authors.forename: Aaron Michael
authors.initials: AM
authors.lastname: Yengo-Kahn
authors.forename: Gary
authors.initials: G
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D001265:Athletic Injuries / Q000175:diagnosis; D001924:Brain Concussion / Q000175:diagnosis; D003863:Depression / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011930:Reaction Time; D057566:Self Report; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs
keywords: Brain concussion; depression; immediate post-concussion assessment and cognitive test; neuropsychological test; psychotropic drugs