scholarly journals Longitudinal effects of using and discontinuing CNS medications on cognitive functioning

2021 ◽  
Author(s):  
Elise Koch ◽  
Kristina Johnell ◽  
Karolina Kauppi
Keyword(s):  
Cognitive Performance ◽  
Semantic Memory ◽  
Cognitive Task ◽  
Drug Discontinuation ◽  
Hypnotics And Sedatives ◽  
Visuospatial Ability ◽  
Cognitive Improvement ◽  
Increased Risk ◽  
Longitudinal Effects ◽  
Antidepressant Use

AbstractBackgroundMedications acting on the central nervous system (CNS) have been associated with accelerated cognitive decline and increased risk of dementia. However, results are inconsistent and the longitudinal effects of CNS medications on cognitive performance are still not known.MethodsUsing longitudinal cognitive data from healthy adults aged 25-100 years (N = 2,475) from four test waves five years apart, we investigated both the link between use of CNS medications (opioids, antidepressants, 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.

The Effect of Mianserin on Lifespan of Caenorhabditis elegans is Abolished by Glucose

2021 ◽  
Vol 13 ◽  
Author(s):  
Abdullah Almotayri ◽  
Jency Thomas ◽  
Mihiri Munasinghe ◽  
Markandeya Jois
Keyword(s):  
Caenorhabditis Elegans ◽  
Scaffolding Protein ◽  
Lifespan Extension ◽  
Wild Type ◽  
E Coli ◽  
C Elegans ◽  
Risk Of Death ◽  
Increased Risk ◽  
Antidepressant Use ◽  
Extension Effect

Background: The antidepressant mianserin has been shown to extend the lifespan of Caenorhabditis elegans (C. elegans), a well-established model organism used in aging research. The extension of lifespan in C. elegans was shown to be dependent on increased expression of the scaffolding protein (ANK3/unc-44). In contrast, antidepressant use in humans is associated with an increased risk of death. The C. elegans in the laboratory are fed Escherichia coli (E. coli), a diet high in protein and low in carbohydrate, whereas a typical human diet is high in carbohydrates. We hypothesized that dietary carbohydrates might mitigate the lifespan-extension effect of mianserin. Objective: To investigate the effect of glucose added to the diet of C. elegans on the lifespan-extension effect of mianserin. Methods: Wild-type Bristol N2 and ANK3/unc-44 inactivating mutants were cultured on agar plates containing nematode growth medium and fed E. coli. Treatment groups included (C) control, (M50) 50 μM mianserin, (G) 73 mM glucose, and (M50G) 50 μM mianserin and 73 mM glucose. Lifespan was determined by monitoring the worms until they died. Statistical analysis was performed using the Kaplan-Meier version of the log-rank test. Results: Mianserin treatment resulted in a 12% increase in lifespan (P<0.05) of wild-type Bristol N2 worms but reduced lifespan by 6% in ANK3/unc-44 mutants, consistent with previous research. The addition of glucose to the diet reduced the lifespan of both strains of worms and abolished the lifespan-extension by mianserin. Conclusion: The addition of glucose to the diet of C. elegans abolishes the lifespan-extension effects of mianserin.

The Impact of Environmental Stress on Cognitive Performance: A Systematic Review

2019 ◽  
Vol 61 (8) ◽  
pp. 1205-1246 ◽  
Author(s):  
Kristy Martin ◽  
Emily McLeod ◽  
Julien Périard ◽  
Ben Rattray ◽  
Richard Keegan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Environmental Stress ◽  
Task Performance ◽  
Sea Level ◽  
Cognitive Performance ◽  
Cognitive Task ◽  
Individual Characteristics ◽  
Eligibility Criteria ◽  
Healthy Human ◽  
The Impact

Objective: In this review, we detail the impact of environmental stress on cognitive and military task performance and highlight any individual characteristics or interventions which may mitigate any negative effect. Background: Military personnel are often deployed in regions markedly different from their own, experiencing hot days, cold nights, and trips both above and below sea level. In spite of these stressors, high-level cognitive and operational performance must be maintained. Method: A systematic review of the electronic databases Medline (PubMed), EMBASE (Scopus), PsycINFO, and Web of Science was conducted from inception up to September 2018. Eligibility criteria included a healthy human cohort, an outcome of cognition or military task performance and assessment of an environmental condition. Results: The search returned 113,850 records, of which 124 were included in the systematic review. Thirty-one studies examined the impact of heat stress on cognition; 20 of cold stress; 59 of altitude exposure; and 18 of being below sea level. Conclusion: The severity and duration of exposure to the environmental stressor affects the degree to which cognitive performance can be impaired, as does the complexity of the cognitive task and the skill or familiarity of the individual performing the task. Application: Strategies to improve cognitive performance in extreme environmental conditions should focus on reducing the magnitude of the physiological and perceptual disturbance caused by the stressor. Strategies may include acclimatization and habituation, being well skilled on the task, and reducing sensations of thermal stress with approaches such as head and neck cooling.

Psychological interventions as an alternative and add-on to antidepressant medication to prevent depressive relapse: systematic review and meta-analysis

2020 ◽  
pp. 1-8
Author(s):  
Josefien Johanna Froukje Breedvelt ◽  
Maria Elisabeth Brouwer ◽  
Mathias Harrer ◽  
Maria Semkovska ◽  
David Daniel Ebert ◽  
...  
Keyword(s):  
Psychological Intervention ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Cochrane Library ◽  
Psychological Interventions ◽  
Relapse Risk ◽  
Increased Risk ◽  
Antidepressant Use ◽  
Randomised Controlled ◽  
Risk Of Relapse

Background After remission, antidepressants are often taken long term to prevent depressive relapse or recurrence. Whether psychological interventions can be a viable alternative or addition to antidepressants remains unclear. Aims To compare the effectiveness of psychological interventions as an alternative (including delivered when tapering antidepressants) or addition to antidepressants alone for preventing depressive relapse. Method Embase, PubMed, the Cochrane Library and PsycINFO were searched from inception until 13 October 2019. Randomised controlled trials (RCTs) with previously depressed patients in (partial) remission where preventive psychological interventions with or without antidepressants (including tapering) were compared with antidepressant control were included. Data were extracted independently from published trials. A random-effects meta-analysis on time to relapse (hazard ratio, HR) and risk of relapse (risk ratio, RR) at the last point of follow-up was conducted. PROSPERO ID: CRD42017055301. Results Among 11 included trials (n = 1559), we did not observe an increased risk of relapse for participants receiving a psychological intervention while tapering antidepressants versus antidepressants alone (RR = 1.02, 95% CI 0.84–1.25; P = 0.85). Psychological interventions added to antidepressants significantly reduced the risk of relapse (RR = 0.85, 95% CI 0.74–0.97; P = 0.01) compared with antidepressants alone. Conclusions This study found no evidence to suggest that adding a psychological intervention to tapering increases the risk of relapse when compared with antidepressants alone. Adding a psychological intervention to antidepressant use reduces relapse risk significantly versus antidepressants alone. As neither strategy is routinely implemented these findings are relevant for patients, clinicians and guideline developers.

scholarly journals The effect of age on postural and cognitive task performance while using vibrotactile feedback

2015 ◽  
Vol 113 (7) ◽  
pp. 2127-2136 ◽  
Author(s):  
Chia-Cheng Lin ◽  
Susan L. Whitney ◽  
Patrick J. Loughlin ◽  
Joseph M. Furman ◽  
Mark S. Redfern ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Center Of Pressure ◽  
Cognitive Task ◽  
Balance Performance ◽  
Vibrotactile Feedback ◽  
Younger Adults ◽  
Age Related ◽  
Trunk Tilt ◽  
Effect Of Age

Vibrotactile feedback (VTF) has been shown to improve balance performance in healthy people and people with vestibular disorders in a single-task experimental condition. It is unclear how age-related changes in balance affect the ability to use VTF and if there are different attentional requirements for old and young adults when using VTF. Twenty younger and 20 older subjects participated in this two-visit study to examine the effect of age, VTF, sensory condition, cognitive task, duration of time, and visit on postural and cognitive performance. Postural performance outcome measures included root mean square of center of pressure (COP) and trunk tilt, and cognitive performance was assessed using the reaction time (RT) from an auditory choice RT task. The results showed that compared with younger adults, older adults had an increase in COP in fixed platform conditions when using VTF, although they were able to reduce COP during sway-referenced platform conditions. Older adults also did not benefit fully from using VTF in their first session. The RTs for the secondary cognitive tasks increased significantly while using the VTF in both younger and older adults. Older adults had a larger increase compared with younger adults, suggesting that greater attentional demands were required in older adults when using VTF information. Future training protocols for VTF should take into consideration the effect of aging.

scholarly journals Outcomes from an inpatient beta-lactam allergy guideline across a large US health system

2019 ◽  
Vol 40 (05) ◽  
pp. 528-535 ◽  
Author(s):  
Kimberly G. Blumenthal ◽  
Yu Li ◽  
Joyce T. Hsu ◽  
Anna R. Wolfson ◽  
David N. Berkowitz ◽  
...  
Keyword(s):  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Test Dose ◽  
Drug Discontinuation ◽  
Beta Lactam ◽  
Multivariable Logistic Regression Model ◽  
Model Modification ◽  
Increased Risk ◽  
Lactam Antibiotic ◽  
Dose Step

AbstractObjective:To assess the safety of, and subsequent allergy documentation associated with, an antimicrobial stewardship intervention consisting of test-dose challenge procedures prompted by an electronic guideline for hospitalized patients with reported β-lactam allergies.Design:Retrospective cohort study.Setting:Large healthcare system consisting of 2 academic and 3 community acute-care hospitals between April 2016 and December 2017.Methods:We evaluated β-lactam antibiotic test-dose outcomes, including adverse drug reactions (ADRs), hypersensitivity reactions (HSRs), and electronic health record (EHR) allergy record updates. HSR predictors were examined using a multivariable logistic regression model. Modification of the EHR allergy record after test doses considered relevant allergy entries added, deleted, and/or specified.Results:We identified 1,046 test-doses: 809 (77%) to cephalosporins, 148 (14%) to penicillins, and 89 (9%) to carbapenems. Overall, 78 patients (7.5%; 95% confidence interval [CI], 5.9%–9.2%) had signs or symptoms of an ADR, and 40 (3.8%; 95% CI, 2.8%–5.2%) had confirmed HSRs. Most HSRs occurred at the second (ie, full-dose) step (68%) and required no treatment beyond drug discontinuation (58%); 3 HSR patients were treated with intramuscular epinephrine. Reported cephalosporin allergy history was associated with an increased odds of HSR (odds ratio [OR], 2.96; 95% CI, 1.34–6.58). Allergies were updated for 474 patients (45%), with records specified (82%), deleted (16%), and added (8%).Conclusion:This antimicrobial stewardship intervention using β-lactam test-dose procedures was safe. Overall, 3.8% of patients with β-lactam allergy histories had an HSR; cephalosporin allergy histories conferred a 3-fold increased risk. Encouraging EHR documentation might improve this safe, effective, and practical acute-care antibiotic stewardship tool.

The Impact of Cognitive Load on Volitional Running

2016 ◽  
Vol 60 (1) ◽  
pp. 1179-1183 ◽  
Author(s):  
Megan J. Blakely ◽  
Kyle Wilson ◽  
Paul N. Russell ◽  
William S. Helton
Keyword(s):  
Physical Activity ◽  
Cognitive Load ◽  
Cognitive Performance ◽  
Cognitive Task ◽  
High Load ◽  
Interactive Effects ◽  
Cognitive Tasks ◽  
Running Speed ◽  
Original Experiment ◽  
The Impact

The effects of physical activity on cognition and the effects of cognitive load on physical activity are complex. Both the nature of the physical activity and cognitive task may influence the interactive effects of performing a physical task while also performing a cognitive task. In a previous study examining the impact of increasing cognitive load on outdoor running speed and the impact of outdoor running on cognitive performance, Blakely et al. (2015) found running speed decreased as cognitive load increased. They also found that the impact of running itself on cognitive performance occurred when the cognitive task was itself demanding (high cognitive load). In the current study we expanded on this previous research by improving the experimental task to rule out peripheral sensory, not central or executive, interference and by incorporating heart rate measures and VO2 max estimates. Twelve runners completed five conditions, two seated cognitive tasks (one low load and one high load), two dual running cognitive tasks and one run only. Results were similar to the original experiment, as the cognitive task became more difficult, voluntary running speed decreased. Also the effects of running on cognitive performance (counting) were found only when the cognitive task was high load.

Evaluating depression and suicidality in tetrabenazine users with Huntington disease

Neurology ◽  
2018 ◽  
Vol 91 (3) ◽  
pp. e202-e207 ◽  
Author(s):  
Jordan L. Schultz ◽  
Annie Killoran ◽  
Peg C. Nopoulos ◽  
Chloe C. Chabal ◽  
David J. Moser ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Huntington Disease ◽  
Cross Sectional Study ◽  
Cag Repeat ◽  
Cross Sectional ◽  
Increased Risk ◽  
History Of ◽  
Antidepressant Use ◽  
History Of Depression ◽  
Total Functional Capacity

ObjectiveTo determine whether tetrabenazine (TBZ) use is associated with an increased incidence of depression and/or suicidal ideation.MethodsIn this retrospective cross-sectional study of the Enroll-HD database, we used multiple logistic regression analyses to determine whether TBZ use is associated with an increased incidence of depression and/or suicidal ideation. For both dependent variables (depression and suicidality), separate analyses were conducted on (1) all participants, (2) only participants with a history of depression, and (3) only participants with no history of depression. Adjustments were made for CAG repeat length, total motor score, total functional capacity, Symbol Digit Modalities Test score, sex, disease duration, history of depression (when applicable), antipsychotic use, and antidepressant use.ResultsCompared to participants who were not using TBZ (n = 3,548), TBZ users (n = 543) did not have an increased risk of depression (odds ratio [OR] = 0.78, p = 0.064). Participants taking TBZ actually had a relatively lower risk of suicidality (OR = 0.61, p = 0.043). Among only participants with a history of depression, those using TBZ had a lower incidence of depression (OR = 0.71, p = 0.016) and suicidal ideation (OR = 0.57, p = 0.028) compared to those not using TBZ. Finally, among only participants with no history of depression, TBZ use was not associated with a higher incidence of depression (OR = 1.59, p = 0.18) or suicidality (OR = 1.43, p = 0.66) compared to those who were not using TBZ.ConclusionsTBZ use was not associated with an increased incidence of depression or suicidality. These findings suggest that TBZ may be safe to use in patients with Huntington disease who have a history of depression.

The Impact of Auditory White Noise on Cognitive Performance

2021 ◽  
pp. 1-15
Author(s):  
Nicole Baum ◽  
Jasleen Chaddha
Keyword(s):  
White Noise ◽  
Cognitive Performance ◽  
Temporal Order ◽  
Tuning Curve ◽  
Prior Exposure ◽  
Cognitive Improvement ◽  
Temporal Order Judgement ◽  
Task Irrelevant ◽  
The Impact ◽  
Amplitude Discrimination

Although noise has often been characterized as a distractor, contemporary studies have emphasized how some individuals’ cognitive performance could benefit from task-irrelevant noise. Usually these studies focus on sub-attentive individuals and/or those who have been diagnosed with ADHD. An example of task-irrelevant noise is white noise (WN). Research regarding the effectiveness of WN in healthy adults has provided mixed results and therefore, the implications of WN remain unknown. The objective of this study was to determine the effects of WN on the cognitive performance of the neurotypical population. To test this, participants were asked to complete simultaneous amplitude discrimination and temporal order judgement (TOJ) tests several times in the presence of varying levels of WN. Participants were split into two groups––one containing individuals with regular prior WN exposure and the other with no previous experience with WN. The performances of participants with prior exposure to WN, but not those without prior exposure, resembled a U-shaped tuning curve for simultaneous amplitude discrimination. This indicates that familiarity with WN moderates its effectiveness on cognitive improvement. TOJ was not found to be affected by varying levels of WN intensity. The results of this study emphasized that there is a possibility that WN could facilitate higher levels of cognitive performance, though there is likely an adjustment period associated with its introduction to daily life. This warrants that additional research should be conducted in order to cultivate a definitive conclusion about the effects of WN.

scholarly journals Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025908 ◽  
Author(s):  
Maëlle Dandjinou ◽  
Odile Sheehy ◽  
Anick Bérard
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Index Date ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
Antidepressant Use ◽  
Nested Case Control ◽  
Control Study

ObjectivesThe aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and settingA nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015.Primary outcome measuresGestational diabetes mellitus.ParticipantsCases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR).ResultsAmong 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors.ConclusionThe findings suggest that ADs—and specifically venlafaxine and amitriptyline—were associated with an increased risk of GDM.

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