Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment and self-reported side effects in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort.
European Neuropsychopharmacology. 2023-12-01; 77: 67-79
DOI: 10.1016/j.euroneuro.2023.08.502
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1. Eur Neuropsychopharmacol. 2023 Dec;77:67-79. doi:
10.1016/j.euroneuro.2023.08.502. Epub 2023 Sep 21.
Comparative analysis of anticholinergic burden scales to explain iatrogenic
cognitive impairment and self-reported side effects in the euthymic phase of
bipolar disorders: Results from the FACE-BD cohort.
Vidal N(1), Brunet-Gouet E(2), Frileux S(2), Aouizerate B(3), Aubin V(4),
Belzeaux R(5), Courtet P(6), D’Amato T(7), Dubertret C(8), Etain B(9), Haffen
E(10), Januel D(11), Leboyer M(12), Lefrere A(13), Llorca PM(14), Marlinge E(9),
Olié E(6), Polosan M(15), Schwan R(16), Walter M(17); FACE-BD (FondaMental
Academic Centers of Expertise for Bipolar Disorders) group; Passerieux C(2),
Roux P(2).
Collaborators: Etain B(18), Olié E(18), Leboyer M(18), Haffen E(18), Llorca
PM(18), Barteau V(19), Bensalem S(19), Godin O(19), Laouamri H(19), Souryis
K(19), Hotier S(20), Pelletier A(20), Drancourt N(20), Sanchez JP(20), Saliou
E(20), Hebbache C(20), Petrucci J(20), Willaume L(20), Bourdin E(20), Bellivier
F(21), Carminati M(21), Etain B(21), Marlinge E(21), Meheust J(21), Hennion
V(21), Francisque H(21), Aouizerate B(22), Da Ros N(22), Desage A(22), Elkael
C(22), Gard S(22), Hoorelbeke F(22), M’bailara K(22), Minois I(22), Sportich
J(22), Boukhobza L(23), Benramdane M(23), Courtet P(23), Deffinis B(23), Denat
S(23), Ducasse D(23), Gachet M(23), Molière F(23), Nass L(23), Olié E(23),
Tarquini G(23), Belzeaux R(24), Cermolacce M(24), Groppi F(24), Moreau E(24),
Lefrere A(24), Lescalier L(24), Pastol J(24), Viglianese N(24), Cohen R(25),
Gross G(25), Schwan R(25), Schwitzer T(25), Wajsbrot-Elgrabli O(25), Bougerol
T(26), Fredembach B(26), Denoual Q(26), Bertrand A(26), Pouchon A(26), Polosan
M(26), Bonny G(27), Brehon L(27), Durand L(27), Feuga V(27), Galliot AM(27),
Kayser N(27), Passerieux C(27), Roux P(27), Aubin V(28), Cussac I(28), Dupont
MA(28), Loftus J(28), Medecin I(28), Dubertret C(29), Mazer N(29), Portalier
C(29), Scognamiglio C(29), Bing A(29), Laurent P(29), Llorca PM(30), Samalin
L(30), Foures L(30), Lacelle D(30), Pires S(30), Doriat C(30), Blanc O(30),
Haffen E(31), Bennabi D(31), Nicolier M(31).
Author information:
(1)Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles,
Service Hospitalo-Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le
Chesnay; Université Paris-Saclay, Université de Versailles
Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif,
France. Electronic address: .
(2)Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles,
Service Hospitalo-Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le
Chesnay; Université Paris-Saclay, Université de Versailles
Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR 1018, Villejuif,
France.
(3)Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens,
Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux,
France.
(4)Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre
Hospitalier Princesse Grace, Monaco.
(5)Fondation FondaMental, Créteil, France; Pôle universitaire de psychiatrie,
CHU de Montpellier, Montpellier, France; INT-UMR7289, CNRS Aix-Marseille
Université, Marseille, France.
(6)Fondation FondaMental, Créteil, France; CHU Montpellier, Hôpital Lapeyronie,
Psychiatric Emergency and Post Emergency Department, Pole Urgence; IGF,
Université de Montpellier, CNRS, INSERM, Montpellier, France.
(7)Fondation FondaMental, Créteil, France; University Lyon 1, Villeurbanne;
INSERM, U1028; CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric
Disorders: From Resistance to Response Team, Lyon, France.
(8)Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire
AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis
Mourier, Colombes, France, Université de Paris, Inserm UMR1266, Sorbonne Paris
Cité, Faculté de Médecine, Paris, France.
(9)Fondation FondaMental, Créteil, France; Assistance publique des Hôpitaux de
Paris, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital
Fernand Widal, Département de Psychiatrie et de Médecine Addictologique,
Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en
Neuropsychopharmacologie OTeN, Paris, France.
(10)Fondation FondaMental, Créteil, France; Service de Psychiatrie de l’Adulte,
CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC,
Besançon, France.
(11)Fondation FondaMental, Créteil, France; Unité de Recherche Clinique, EPS
Ville-Evrard, 93332 Neuilly-sur-Marne, France.
(12)Fondation FondaMental, Créteil, France; Univ Paris Est Créteil, INSERM U955,
IMRB, Translational NeuroPsychiatry Laboratory,; AP-HP, Hôpitaux Universitaires
Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie
(DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en
Psychiatrie (FHU ADAPT), Créteil, France.
(13)Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance
Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS
Aix-Marseille Université, Marseille, France.
(14)Fondation FondaMental, Créteil, France; Centre Hospitalier et Universitaire,
Département de Psychiatrie, Université d’Auvergne, EA 7280, Clermont-Ferrand,
France.
(15)Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216,
CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France.
(16)Fondation FondaMental, Créteil, France; Université de Lorraine, Centre
Psychothérapique de Nancy, Inserm U1254, Nancy, France.
(17)Fondation FondaMental, Créteil, France; Service Hospitalo-Universitaire de
Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02, CHRU de
Brest, Hôpital de Bohars, Brest, France.
(18)FACE-BD Clinical Coordinating Center (Fondation FondaMental).
(19)FACE-BD Data Coordinating Center (Fondation FondaMental).
(20)FACE-BD Clinical Sites and Principal Collaborators in France. AP-HP, DHU
PePSY, Pôle de Psychiatrie et d’Addictologie des Hôpitaux Universitaires H
Mondor, Créteil.
(21)AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris.
(22)Hôpital C. Perrens, Center Expert Trouble Bipolaire, Service de Psychiatrie
Adulte, Pôle 3-4-7, Bordeaux.
(23)Département d’Urgence et Post Urgence Psychiatrique, CHRU Montpellier,
Montpellier.
(24)Pôle de Psychiatrie, Addictologie et Pédopsychiatrie, Hôpital Sainte
Marguerite, Marseille.
(25)Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254,
Nancy, France.
(26)Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes,
Grenoble.
(27)Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie
d’Adultes et d’Addictologie, Le Chesnay.
(28)Centre Hospitalier Princesse Grace, Monaco.
(29)APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de
Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France.
(30)Service de Psychiatrie de l’adulte B, Centre Expert Trouble Bipolaire, CHU
de Clermont-Ferrand, Clermont-Ferrand, France.
(31)Service de Psychiatrie de l’Adulte, Centre Expert Bipolaire du CHU de
Besançon (F-25000), Besançon, France.
Bipolar disorders (BD) are characterized by cognitive impairment during the
euthymic phase, to which treatments can contribute. The anticholinergic
properties of medications, i.e., the ability of a treatment to inhibit
cholinergic receptors, are associated with cognitive impairment in elderly
patients and people with schizophrenia but this association has not been well
characterized in individuals with remitted BD. Moreover, the validity of only
one anticholinergic burden scale designed to assess the anticholinergic load of
medications has been tested in BD. In a literature review, we identified 31
existing scales. We first measured the associations between 27 out of the 31
scales and objective cognitive impairment in bivariable regressions. We then
adjusted the bivariable models with covariates: the scales significantly
associated with cognitive impairment in bivariable and multiple logistic
regressions were defined as having good concurrent validity to assess cognitive
impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a
neuropsychological battery, two scales had good concurrent validity to assess
cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents,
the number of antipsychotics, or the number of treatments had not. Finally,
similar analyses with subjective anticholinergic side-effects as outcome
variables reported 14 scales with good concurrent validity to assess
self-reported peripheral anticholinergic side-effects and 13 to assess
self-reported central anticholinergic side-effects. Thus, we identified valid
scales to monitor the anticholinergic burden in BD, which may be useful in
estimating iatrogenic cognitive impairment in studies investigating cognition in
BD.
Copyright © 2023 Elsevier B.V. and ECNP. All rights reserved.
DOI: 10.1016/j.euroneuro.2023.08.502
PMID: 37741163 [Indexed for MEDLINE]
Conflict of interest statement: Conflicts of interest All authors declare that
they have no conflicts of interest.