Sensitivity of Schizophrenia Endophenotype Biomarkers to Anticholinergic Medication Burden

While schizophrenia is characterized by generalized cognitive deficits across the course of illness. emerging evidence suggests many medications can also negatively impact cognitive performance. Joshi et al recently reported that anticholinergic medication burden (ACMB) accumulated from multiple medication classes--antipsychotics, antidepressants, and traditional anticholinergics--is associated with deficits across nearly all cognitive measures in individuals with schizophrenia in the cross-sectional, multi-site Consortium on the Genetics of Schizophrenia study (COGS-2)(5). While studies have shown that mismatch negativity/P3a arc resistant to fluctuations in clinical state and symptoms, and are largely unaffected by individual antipsychotic medications or when switching between antipsychotics, the emphasis of those reports was on individual antipsychotic medications rather than total ACMB. Here, they directly evaluated whether these neuropilysiological biomarkers of early auditory information processing are associated with degree of ACMB in a large schizophrenia cohort.