The effect of anticholinergic burden on cognitive and daily living functions in patients with schizophrenia

Abstract Objective This study aimed to explore the association between medication-associated anticholinergic burden and cognitive and daily living functions in patients with schizophrenia. Methods Sixty patients with schizophrenia were recruited. We used the Anticholinergic Drug Scale (ADS) for evaluating medication-associated anticholinergic burden. The MATRICS Consensus Cognitive Battery (MCCB) and the University of California San Diego Performance-based Skills Assessment (UPSA) were used for evaluating cognitive and daily living functions. To assess clinical symptoms, psychiatrists conducted interviews using the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. Results Subjects were divided into low (n = 31) and high (n = 29) anticholinergic burden based on ADS scores of 3 or more. The “high ADS” group had poorer cognitive (composite MCCB score, p  Conclusions Our analysis shows that anticholinergic burden reduces cognitive and daily living functions in patients with schizophrenia. A drug strategy with minimal anticholinergic burden may be helpful to patients if it does not adversely affect clinical symptoms.