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Associations between medication use and multiple domains of cognitive function in people with multiple Sclerosis
Jeeyeon Kim1, Keara M Ginell1, Serena Marecle1
1Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, United States.
Multiple Sclerosis and Related Disorders
|November 19, 2025
Summary
Certain medications impact cognitive function in multiple sclerosis (MS). Opioid use was linked to worse executive function, while antidepressants and corticosteroids showed benefits for processing speed and memory, respectively.
Area of Science:
- Neurology
- Pharmacology
- Cognitive Science
Background:
- Multiple sclerosis (MS) management often involves polypharmacy.
- The specific impact of medication classes on cognitive function in MS is not well understood.
- This study investigates medication effects on cognition in individuals with MS.
Purpose of the Study:
- To examine associations between commonly used medications and cognitive outcomes in people with MS.
- To differentiate effects on objective and subjective cognitive measures.
Main Methods:
- Secondary analysis of baseline data from 260 individuals with MS.
- Self-reported medication use.
- Objective cognitive assessment (NIH Toolbox, SDMT, PASAT, RAVLT) and subjective assessment (PROMIS Cognitive Function Abilities Short Form).
- Multivariable linear regression adjusted for covariates.
Main Results:
- Participants used a median of 6 medications.
- Opioid analgesic use correlated with poorer executive function.
- Antidepressant use was associated with improved processing speed.
- Corticosteroid use linked to enhanced memory across multiple domains.
- No significant associations found for other common medication classes.
Conclusions:
- Medication choices in MS patients can influence cognitive health.
- Consideration of cognitive side effects and benefits is crucial in pharmacologic decision-making for MS.
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