University of Oulu

Anja P. Husa, Jani Moilanen, Graham K. Murray, Riikka Marttila, Marianne Haapea, Irina Rannikko, Jennifer H. Barnett, Peter B. Jones, Matti Isohanni, Anne M. Remes, Hannu Koponen, Jouko Miettunen, Erika Jääskeläinen, Lifetime antipsychotic medication and cognitive performance in schizophrenia at age 43 years in a general population birth cohort, Psychiatry Research, Volume 247, 2017, Pages 130-138, ISSN 0165-1781,

Lifetime antipsychotic medication and cognitive performance in schizophrenia at age 43 years in a general population birth cohort

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Author: Husa, Anja P.1,2,3; Moilanen, Jani1,2,3; Murray, Graham K.4;
Organizations: 1Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90029 OYS, Oulu, Finland
4Department of Psychiatry, University of Cambridge, Box 189 Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
5Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
6Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS, Finland
7Cambridge Cognition Ltd., Tunbridge Court, Bottisham, Cambridge, United Kingdom
8Department of Psychiatry, University of Cambridge, Herchel Smith Building, Cambridge CB2 0SZ, United Kingdom
9Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
10Department of Neurology, Kuopio University Hospital, Kuopio, Finland
11University of Helsinki and Helsinki University Hospital – Psychiatry, P.O. Box 22, 00014 Helsinki, Finland
12Oulu Occupational Health, Hallituskatu 36 B, 90100 Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Elsevier, 2017
Publish Date: 2019-07-31


This naturalistic study analysed the association between cumulative lifetime antipsychotic dose and cognition in schizophrenia after an average of 16.5 years of illness. Sixty participants with schizophrenia and 191 controls from the Northern Finland Birth Cohort 1966 were assessed at age 43 years with a neurocognitive test battery. Cumulative lifetime antipsychotic dose-years were collected from medical records and interviews. The association between antipsychotic dose-years and a cognitive composite score based on principal component analysis was analysed using linear regression. Higher lifetime antipsychotic dose-years were significantly associated with poorer cognitive composite score, when adjusted for gender, onset age and lifetime hospital treatment days. The effects of typical and atypical antipsychotics did not differ. This is the first report of an association between cumulative lifetime antipsychotic dose and global cognition in midlife schizophrenia. Based on these data, higher lifetime antipsychotic dose-years may be associated with poorer cognitive performance at age 43 years. Potential biases related to the naturalistic design may partly explain the results; nonetheless, it is possible that large antipsychotic doses harm cognition in schizophrenia in the long-term.

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Series: Psychiatry research
ISSN: 0165-1781
ISSN-E: 1872-7123
ISSN-L: 0165-1781
Volume: 247
Pages: 130 - 138
DOI: 10.1016/j.psychres.2016.10.085
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: Funding for this study was provided by the Academy of Finland Grants 132 071, 278 286 and 268 336, the Sigrid Jusélius Foundation,the Brain & Behavior Research Foundation, the Jalmari and Rauha Ahokas Foundation, the Emil Aaltonen Foundation, the Finnish Cultural Foundation Lapland Regional Fund, the Northern Finland Health Care Support Foundation and the UK Medical Research Council Grant G0701911. J.H.B. was an employee of Cambridge Cognition.
Academy of Finland Grant Number: 132071
Detailed Information: 132071 (Academy of Finland Funding decision)
278286 (Academy of Finland Funding decision)
268336 (Academy of Finland Funding decision)
Copyright information: © 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license (