Cholinergic Functioning, Cognition, and Anticholinergic Medication Burden in Schizophrenia

Curr Top Behav Neurosci. 2023:63:393-406. doi: 10.1007/7854_2022_400.

Abstract

Acetylcholine (ACh) signaling is critical for central nervous function and is known to be abnormal in schizophrenia (SZ), a chronic neuropsychiatric disorder in which cognitive deficits persist, despite treatment. This review provides a summary of the clinical evidence linking ACh abnormalities to SZ-associated cognitive deficits, an overview of ACh-based pro-cognitive strategies attempted in SZ, and a survey of recent studies that describe the impact of anticholinergic medication burden on cognitive outcomes in SZ. Methodological challenges that currently limit more substantial investigation of ACh in SZ patients and future directions are also discussed.

Keywords: Anticholinergic; Cognition; Muscarinic receptor; Nicotinic receptor; Schizophrenia.

Publication types

  • Review

MeSH terms

  • Acetylcholine
  • Cholinergic Antagonists / therapeutic use
  • Cognition
  • Cognition Disorders* / drug therapy
  • Cognitive Dysfunction*
  • Humans
  • Schizophrenia* / drug therapy

Substances

  • Cholinergic Antagonists
  • Acetylcholine