Drug-induced cognitive impairment
Many classes of medications, such as antipsychotics, anticonvulsants, anticholinergics, and other commonly prescribed drugs, can cause cognitive impairment (CI). The negative effect of drugs on cognitive functions is due to the following pathophysiological mechanisms: a reduction in neuronal excitab...
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| Format: | Article |
| Language: | Russian |
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IMA-PRESS LLC
2020-06-01
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| Series: | Неврология, нейропсихиатрия, психосоматика |
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| Online Access: | https://nnp.ima-press.net/nnp/article/view/1352 |
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| author | O. D. Ostroumova M. I. Kulikova T. M. Ostroumova M. S. Chernyaeva A. I. Kochetkov V. A. Parfenov |
| author_facet | O. D. Ostroumova M. I. Kulikova T. M. Ostroumova M. S. Chernyaeva A. I. Kochetkov V. A. Parfenov |
| author_sort | O. D. Ostroumova |
| collection | DOAJ |
| description | Many classes of medications, such as antipsychotics, anticonvulsants, anticholinergics, and other commonly prescribed drugs, can cause cognitive impairment (CI). The negative effect of drugs on cognitive functions is due to the following pathophysiological mechanisms: a reduction in neuronal excitability, an increase in gamma-aminobutyric acid activity, and decreases in enzyme activity, the number of receptors, cerebral perfusion, as well as brain atrophy; moreover, a number of mechanisms have not been fully studied. An important role in the development of drug-induced CI is played by predisposing (senility or childhood, brain damage, chronic diseases, functional disorders, genetic causes, initial cognitive decline, polypragmasia), and precipitating (acute diseases, infections, metabolic disorders, dehydration, acute urinary retention, malnutrition, environmental influences, etc.) factors. The dose of a drug, the duration of its use is of absolute value. There is a need for the differential diagnosis of CI induced by drugs and CI directly related to the diseases, for which these drugs are prescribed. Drug-induced CI should be suspected if an association is established between a decline of cognitive functions and the start of drug intake. The treatment of this CI involves primarily dose withdrawal or reduction and the use of sustained-release dosage forms, if available. In some cases, cognitive training and/or special drug therapy may be required to correct the CI that has occurred. The measures to prevent drug-induced KI include the choice of the lowest-risk drugs, the use of current side-effect rating scales, in particular an anticholinergic burden scale. |
| first_indexed | 2024-04-10T02:02:33Z |
| format | Article |
| id | doaj.art-eb9ef846ba364681a9ea88b54b66cdf5 |
| institution | Directory Open Access Journal |
| issn | 2074-2711 2310-1342 |
| language | Russian |
| last_indexed | 2024-04-10T02:02:33Z |
| publishDate | 2020-06-01 |
| publisher | IMA-PRESS LLC |
| record_format | Article |
| series | Неврология, нейропсихиатрия, психосоматика |
| spelling | doaj.art-eb9ef846ba364681a9ea88b54b66cdf52023-03-13T08:42:19ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422020-06-01123111810.14412/2074-2711-2020-3-11-18988Drug-induced cognitive impairmentO. D. Ostroumova0M. I. Kulikova1T. M. Ostroumova2M. S. Chernyaeva3A. I. Kochetkov4V. A. Parfenov5Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaWar Veterans Hospital Two, Moscow Healthcare DepartmentRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaMany classes of medications, such as antipsychotics, anticonvulsants, anticholinergics, and other commonly prescribed drugs, can cause cognitive impairment (CI). The negative effect of drugs on cognitive functions is due to the following pathophysiological mechanisms: a reduction in neuronal excitability, an increase in gamma-aminobutyric acid activity, and decreases in enzyme activity, the number of receptors, cerebral perfusion, as well as brain atrophy; moreover, a number of mechanisms have not been fully studied. An important role in the development of drug-induced CI is played by predisposing (senility or childhood, brain damage, chronic diseases, functional disorders, genetic causes, initial cognitive decline, polypragmasia), and precipitating (acute diseases, infections, metabolic disorders, dehydration, acute urinary retention, malnutrition, environmental influences, etc.) factors. The dose of a drug, the duration of its use is of absolute value. There is a need for the differential diagnosis of CI induced by drugs and CI directly related to the diseases, for which these drugs are prescribed. Drug-induced CI should be suspected if an association is established between a decline of cognitive functions and the start of drug intake. The treatment of this CI involves primarily dose withdrawal or reduction and the use of sustained-release dosage forms, if available. In some cases, cognitive training and/or special drug therapy may be required to correct the CI that has occurred. The measures to prevent drug-induced KI include the choice of the lowest-risk drugs, the use of current side-effect rating scales, in particular an anticholinergic burden scale.https://nnp.ima-press.net/nnp/article/view/1352cognitive impairmentdrug-induced cognitive impairmentadverse drug reactions |
| spellingShingle | O. D. Ostroumova M. I. Kulikova T. M. Ostroumova M. S. Chernyaeva A. I. Kochetkov V. A. Parfenov Drug-induced cognitive impairment Неврология, нейропсихиатрия, психосоматика cognitive impairment drug-induced cognitive impairment adverse drug reactions |
| title | Drug-induced cognitive impairment |
| title_full | Drug-induced cognitive impairment |
| title_fullStr | Drug-induced cognitive impairment |
| title_full_unstemmed | Drug-induced cognitive impairment |
| title_short | Drug-induced cognitive impairment |
| title_sort | drug induced cognitive impairment |
| topic | cognitive impairment drug-induced cognitive impairment adverse drug reactions |
| url | https://nnp.ima-press.net/nnp/article/view/1352 |
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