Benzodiazepine long-term administration is associated with impaired attention/working memory in schizophrenia: results from the national multicentre FACE-SZ data set

• Published in: European archives of psychiatry and clinical neuroscience Vol. 268; no. 1; pp. 17 - 26
• Main Authors: Fond, Guillaume, Berna, F., Boyer, L., Godin, O., Brunel, L., Andrianarisoa, M., Aouizerate, B., Capdevielle, D., Chereau, I., Danion, J. M., Dubertret, C., Dubreucq, J., Faget, C., Gabayet, F., Le Gloahec, T., Llorca, P. M., Mallet, J., Misdrahi, D., Rey, R., Richieri, R., Passerieux, C., Portalier, C., Roux, P., Vehier, A., Yazbek, H., Schürhoff, F., Bulzacka, E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2018; Springer Nature B.V; Springer Verlag
• Subjects: Adult; Antipsychotic Agents - adverse effects; Anxiety; Attention Deficit Disorder with Hyperactivity - chemically induced; Benzodiazepines; Benzodiazepines - adverse effects; Cognitive ability; Cognitive science; Cognitive Sciences; Cohort Studies; Female; Humans; Intelligence; Learning; Life Sciences; Male; Medicine; Medicine & Public Health; Memory; Memory Disorders - chemically induced; Memory, Short-Term - drug effects; Mental disorders; Neurobiology; Neurons and Cognition; Neuropsychological Tests; Neuroscience; Neurosciences; Original Paper; Principal Component Analysis; Psychiatric Status Rating Scales; Psychiatry; Psychology and behavior; Schizophrenia; Schizophrenia - drug therapy; Short term memory; Sleep; Sleep disorders; Schizophrenia; Cognition; Anxiety; Anxiolytics; Benzodiazepine
• DOI: 10.1007/s00406-017-0787-9
• ISSN: 0940-1334; 1433-8491

Objective The effect of benzodiazepine long-term administration (BLTA) in cognitive functioning of subjects with schizophrenia (SZ) has been partially explored to date. The objective was to assess BLTA-associated cognitive impairment with a comprehensive cognitive battery in a non-selected multicentric/national community-dwelling sample of stabilized SZ subjects. Method 407 community-dwelling stabilized SZ subjects were consecutively included in the FondaMental Academic Centers of Expertise for Schizophrenia Cohort (FACE-SZ). Patients taking daily benzodiazepine were defined as BLTA+ as all patients examined by the Expert Center were clinically stabilized and under stable dose of treatment for at least 3 months. Each patient has been administered a 1-day long comprehensive cognitive battery (including The National Adult Reading Test, the Wechsler Adult Intelligence Scale, the Trail Making Test, the California Verbal Learning Test, the Doors test, and The Continuous Performance Test—Identical Pairs). Results In the multivariate analyses, results showed that BLTA was associated with impaired attention/working memory (OR 0.60, 95% confidence interval 0.42–0.86; p  = 0.005) independently of socio-demographic variables and illness characteristics. Verbal and performance current IQ—[respectively, OR 0.98, 95% CI (0.96;0.99), p  = 0.016 and 0.98, 95% CI(0.97;0.99), p  = 0.034] but not premorbid IQ—( p  > 0.05) have been associated with BLTA in a multivariate model including the same confounding variables. Conclusion BLTA is associated with impaired attention/working memory in schizophrenia. The BLTA benefit/risk ratio should be regularly reevaluated. Alternative pharmacological and non-pharmacological strategies for comorbid anxiety disorders and sleep disorders should be preferred when possible. It seems reasonable to withdraw BLTA before the start of cognitive remediation therapy, as soon as possible, to improve the effectiveness of this therapy. Limits: the delay between the last benzodiazepine intake and testing, as well as the specific class of benzodiazepines (long half-life vs. short half-life), and the number of benzodiazepine daily intakes have not been recorded in the present study. The precise motive for BLTA prescription and sleep disturbances have not been reported, which is a limit for the interpretation of the present results.