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The association between psychotropic medications and cognitive functioning in bipolar disorder
Faith Dickerson1, Andrea Origoni2, Emily Katsafanas2
1The Stanley Research Program at Sheppard Pratt, Baltimore, MD, USA. fdickerson@sheppardpratt.org.
International Journal of Bipolar Disorders
|March 5, 2026
Summary
Certain bipolar disorder medications, including ziprasidone, benztropine, and clonazepam, are linked to reduced cognitive function. Doctors should consider these effects when prescribing treatments for bipolar disorder patients.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Bipolar disorder often involves cognitive deficits, even during stable mood states.
- Psychotropic medications are standard treatment, but their cognitive impact is understudied.
Purpose of the Study:
- To investigate the independent association between specific psychotropic medications and cognitive functioning in bipolar disorder patients.
- To explore dose-dependent effects of these medications on cognitive performance.
Main Methods:
- Utilized machine learning (cross-fit LASSO regression) to analyze cognitive test scores (RBANS, Trails A, Letter-Number Sequencing) in 567 bipolar disorder individuals.
- Employed ordered logistic regression to assess medication dosage impacts on cognition, controlling for covariates.
Main Results:
- Ziprasidone, benztropine, and clonazepam were independently associated with significantly lower cognitive scores.
- Benztropine demonstrated a dose-response relationship with all cognitive measures.
- Memory and psychomotor speed were the most affected cognitive domains.
Conclusions:
- Clinicians should consider the cognitive side effects of ziprasidone, benztropine, and clonazepam in bipolar disorder treatment.
- Further interventions are needed to enhance cognitive function and quality of life for individuals with bipolar disorder.
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