Longitudinal effects of using and discontinuing CNS medications on cognitive functioning

Abstract

PurposeTo investigate the longitudinal effect of using and discontinuing central nervous system (CNS) medications on cognitive performance. MethodsUsing longitudinal cognitive data from healthy adults aged 25-100 years (N = 2,188) from four test waves five years apart, we investigated both the link between use of CNS medications (opioids, antidepressants, and anxiolytics, hypnotics and sedatives) on cognitive task performance (episodic memory, semantic memory, visuospatial ability) across 15 years, and the effect of discontinuing these medications in linear mixed effects models. ResultsWe found that opioid use was associated with decline in visuospatial ability, whereas antidepressant use was associated with decline in semantic memory over 15 years. A link between drug discontinuation and cognitive improvement was seen for opioids, antidepressants as well as for anxiolytics, hypnotics and sedatives. ConclusionsAlthough our results may be confounded by subjacent conditions, they suggest that long-term use of CNS medications may have domain-specific negative effects on cognitive performance over time, whereas the discontinuation of these medications may partly reverse these effects. These results open up for future studies that address subjacent conditions on cognition to develop a more complete understanding of the cognitive effects of CNS medications. Key pointsO_LIOpioid use was associated with decline in visuospatial ability, and individuals discontinuing using opioids showed improvement in visuospatial ability compared to individuals continuing using opioids. C_LIO_LIAntidepressant use was associated with decline in semantic memory, and individuals discontinuing using antidepressants showed improvement in semantic memory compared to individuals continuing using antidepressants. C_LIO_LIFor anxiolytics, hypnotics and sedatives there was no difference between continued users and non-users, but drug discontinuation was associated with more positive cognitive development both in episodic memory and visuospatial ability. C_LI