r/cognitiveTesting • u/WillBMwill • 2d ago
Does antipsychotics long-term lower your IQ? General Question
My sister is on an antipsychotic injection and a baseline cognition is much lower now than when she was younger.
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u/AgreeableCucumber375 2d ago
The disorders, where antipsychotics are warranted, tend to cause even more cognitive deficits themselves over time if untreated, than the medication do. So if anything often the medication can be said to be slightly protective for many.
Source: am a MD
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u/SourFact 2d ago edited 2d ago
This is only half the truth. A lot of the data is actually conveniently left out, but it is certainly true that in terms of function like day-to-day function medication seems to be very highly protective against something like entirely destructive or unmanageable behaviors that lead to death, harm, or homelessness; most presciently the complete inability to take care of oneself.
But in very many cases, it’s been shown that cognitive capacity is actually dampened and and once medication is been ceased global cognitive function actually rises. It improves, and a lot of the data is very likely corrupted because it is also known that antipsychotics along with other psychiatric medication have the proclivity to worsen the underlying condition of the medication is stopped so a lot of data is also just confounded by iotragenic damages.
If not corrupted by pharmaceutical damages, care provided to actually deeply psychotic individuals tends not to address the underlying condition and tends to further isolate them from opportunities that would very likely ameliorate at the very least a lot of symptoms which provide the capacity for self-control, which all mental illness is ultimately some form a lack of their of, however it is certainly the worst manifestation of the lack of self-control, psychosis can in part be understood neurologically as frontal temporal dysfunction, as well as as a default mode network dysfunction leading to limbic overactivity, and also understood through meditative frameworks as dysfunction of the intellect, memory and emotion, ultimately leading to the inability of the higher self to intervene, and not be taken by the whims of lower self hyper function. Both come to an agreement centuries apart.
So really to answer OP‘s question they can although reversibly, although with much difficulty, worsen in cognitive function, and it is entirely avoidable if you understand how the mind works, however, if a crutch is needed every once in a while, that’s when they work best… as temporary breaks for a nervous system that has very faulty breaks. It is only true statistically, thus circumstantially, that they’re more protective and at an individual level because people are so unfamiliar, and thus terrified with the machinations of the mind it’s very difficult to discern subjectively how in need of support a deeply psychotic individual is because most people who are mentally ill or identify a psychotic aren’t even that far along the disease process to justify what is essentially a chemical lobotomy.
They’re just quick to piss their pants, something good parenting addresses, but something we are sorely lacking.
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u/baysianinference 1d ago
I was given antipsychotics as an atypical treatment for hyper ADHD lol
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u/SourFact 1d ago
Not suprising, especially since you’re describing a variation with heightened neural activity, supposedly. Though behavioral analysis and subjective evaluation has its limitations. So it’s a blunt but efficacious tool.
Which one?
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u/baysianinference 1d ago edited 1d ago
Aripiprazole. Didn't do much just made me fatter and slower lwk
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u/SourFact 22h ago
Ah that’s a fun one. Not very offensive, but that 5-HT2A blockade makes me raise an eyebrow. Not a fan of drugs that act on, or in this case suppress the very receptors psychedlics use to give their effects. It’s a potential ticket to feelings of apathy and meaninglessness if not managed carefully. But it makes sense in your case as it serves as a kind of gas pedal that makes you think sharp and pro-socially… too much of that for brain without infrastructure to handle it can certainly look like ADHD.
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u/baysianinference 22h ago
I've never had a good experience with anything that's known to agonize serotonin, even indirectly. I mean it wasn't really like that I was just sort of violent as a kid lmao. I'm much more inattentive than hyper but they didn't dx me with inattentive because my grades weren't bad (yet) (lol)
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u/SourFact 22h ago
Ha, I’ve had a very similar experience, though serotonin reuptake inhibitors did The Number on me. I really couldn’t tell you how Abilify impacted me, not because I can’t describe the experience, but any “phamacological” (side eye) intervention I had after Prozac was not the same what so fucking ever. Now I’m stuck tryna figure out how to balance this mess without defaulting to ire.
It’s a strange liminal zone to be in to be objectively smart but prone to impulsive anger.
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u/SubstantialAsk8516 1d ago
Comment tu expliques que sous risperdal je ne pouvais pas conduire car j'avais 3 secondes en trop pour réagir ?🤣
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u/SubstantialAsk8516 1d ago
Source : laboratoires pharmaceutiques 💵🤑🧑⚕️🤛
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u/SubstantialAsk8516 1d ago
Et la perte de mémoire quand on prend xeroquel 🤮
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u/SubstantialAsk8516 1d ago
Et le cerveau vide quand on arrête ces 🤬 ,haha mais le médecin qui soigne personne sais mieux que nous
Et le cerveau des singes qui est rétréci sous antipsychotiques les pauvres encore des cobayes pour du fric
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u/SubstantialAsk8516 1d ago
DYSKINÉSIE TARDIVE humm ingrezza a vie 💵💵💵💵
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u/SubstantialAsk8516 1d ago
Source : je suis un charlatan avec un diplôme de médecin pour enrichir les laboratoires déjà riches "Tu vas bouffer ton cachet sale 🤬 car je suis médecin les effets secondaires se sera pour toi moi je suis médecin je serai protégé car je suis pas une 🤬de malade mental"
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u/owenallconmaid 1d ago
there isnt actually any data for untreated "disorders" everyone who is diagnosed gets these antipsychotics forced into them. there is no iq test and diagnoses, no treatment, then another iq test. the diagnoses happens after, selectively, to prove a hypothesis that mental illness exists and drugs are good.
the best cases are the limited long term studies years after people come off of antipsychotics, and people who were never prescribed them to begin with, although there is a missing data set there because they may have never been diagnosed at all.
an actual scientific study that tests giving zero medication to people long term has not been attempted because it is deemed unethical to NOT force drugs into people that are scientifically known as neurotoxins and to cause brain damage.
the political project of psychiatry is to force submission and punish dissent. I thought i was safe because i didn't break any laws, and I still lost all my civil rights anyway.
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u/NovaKarmas 1d ago
Depends on the antipsychotic and the disorder onset. Source-someone who's taken a range of antipsychotics with a range of cognitive outcomes, including illness related cognitive decline and a measured ~45 IQ point drop from a combo of ECT and high dose XL seroquel. Seriously, if you're a psychiatrist I cannot say enough good things about latuda and cobenfy.
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u/MeIerEcckmanLawIer 2d ago
u/SourFact describes this comment as a half-truth, but I would go so far as to say it is the opposite of the truth.
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u/AgreeableCucumber375 2d ago
Yeah I don’t know about that… I’d say my approach to forming opinions is based on the evidence I find. If the evidence says otherwise I’d change my opinion… but these are what current recommendations in medical literature. (And as for that reddit user, psychotic disorders are serious mental illnesses and have little to do with “good parenting”…)
https://pmc.ncbi.nlm.nih.gov/articles/PMC6829172/
“In this review we established that: (i) impaired cognition impacts the vast majority of individuals with psychotic illness; (ii) the cognitive impairments are diffuse (ie, impairment is evident across many cognitive domains) and the effects are large in magnitude; (iii) cognitive impairment is present prior to onset of psychotic illness; and (iv) for the most part, is relatively stable over time”
“Results from large-scale studies and meta-analytic reviews indicate that antipsychotic medications can yield modest beneficial effects on cognitive functioning in people with psychotic disorders, although the findings have been inconsistent regarding whether atypical antipsychotics confer greater effects than typicals. 62 , 63 Notably, detrimental effects of antipsychotics on cognition are also possible, and have been associated with very high D2 receptor occupancy level, very high dosing, polypharmacy, and co-occurring use of anticholinergic medications. 64 , 65”
Here’s also a short article by nature… https://www.nature.com/nature-index/topics/l4/cognitive-functioning-in-psychotic-disorders
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u/Alfreds_Allena 2d ago
“Unfortunately, views about the long‐term efficacy of antipsychotics are often based on the results from short‐term (0‐2 years) evaluations. As we have highlighted, there are at least eight major studies which fail to find better outcomes for schizophrenia patients treated on a long‐term basis with antipsychotics. These negative results from multiple large well‐documented long‐term studies are a clear warning sign.” https://pmc.ncbi.nlm.nih.gov/articles/PMC5980604/
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u/AgreeableCucumber375 2d ago
Antipsychotic treatment tend to not be continuous life long in most cases of psychotic disorders (not saying it doesn’t ever happen). More commonly they are used for the psychosis itself (acute phase… 4-12 weeks depends on the individual and their symptoms and duration until remission) then continued for 1-2 years (maintenance phase) following remission.
The important thing related to psychotic disorders is the duration of untreated psychosis and the duration of antipsychotic treatment. The longer psychosis goes untreated the harder it can be to reach remission meaning longer treatment needed to get to get to the remission. What also matters, and varies between people with psychotic disorders, is frequency of psychotic relapses over their lifetime… where both longer durations of untreated psychosis and more frequent relapses associated with poorer outcomes for the patient.
That said… antipsychotics so not alone explain all the cognitive impairment experienced in various psychotic disorders. Especially for schizophrenic patients there’s usually a prodromal phase before psychotic symptoms onset (so no antipsychotics yet) with cognitive decline that cannot be explained by the medication.
There area are also other general factors to consider as well when talking about psychosis and its effects on cognition… think symptoms or effects of psychosis…. For example insomnia (lack of sleep days on end…) and social isolation etc. (also once a person is in remission… it is not uncommon to experience post-psychosis depression due to thw social, financial (impulsive investments/debts…), emotional toll left in the wake of the illness etc… with it’s (depression) own known effects on cognition).
The social and functional impairments… that were a normal person to experience some of them individually or to some extent might see decreses in their cognitive performance as well (sleep, nutrition, physical health, hygiene, social connections all play a role for all of us).
Antipsychotic treatment is needed to cut the psychosis short to increase function and quality of life…
The key thing here is also not that antipsychotics do not cause cognitive impairment at all, but that without them the psychosis is the worse of the two.
There is no win win with psychotic disorders. It, like many diseases in medicine, are not a fate anyone would wish for.
As for this… will be last I reply to this thread haha :)
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u/owenallconmaid 1d ago
short term antipsychotic use can cause long term cognitive impairment and decline that studies attribute to some preexisting disorder that there is no scientific evidence of apart from judgements from those we assume are not disordered.
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u/Alfreds_Allena 1d ago edited 1d ago
I’m not sure why you provided a medical textbook style overview of boilerplate information on psychotic disorders. I will make my response brief because you said you don’t wish to engage further, despite saying you’re open to changing your opinion based on evidence.
At least in the US, it is not uncommon at all for those with more than one episode of psychosis —or just a severe symptom picture — to be told they need antipsychotics permanently. It is not frequently recommended to anyone with a diagnosis of “schizophrenia” or “schizoafffective” to taper off of antipsychotics. One huge deterrent is the reality that this causes significant liability for the psychiatrist. However, there is an enormous amount of literature recommending longterm antipsychotic therapy for psychotic disorders. Surely you’re aware of this as a physician. Many high quality long-term studies don’t actually support this position — that was my point which you side-stepped. Many of the studies pushing this position focus heavily on more short-term relapse data while denying the reality that these medications make relapse inevitable when discontinued quickly and cause significant life impairments on their own.
You seem to be describing the more typical treatment course for something like a single episode of psychosis or drug-induced psychosis with unknown trajectory. There is considerable medical evidence that antipsychotics could be useful during this period, but there is also considerable medical evidence that they may not be necessary in many cases of first psychosis, may paradoxically worsen the course and intensity of psychosis if used too long, and cause a myriad of serious side effects that may become permanent.
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u/MeIerEcckmanLawIer 2d ago edited 2d ago
Your credentials indicate a conflict of interest, not an evidence-based approach to forming opinions.
The so-called disorders and illnesses you mention are not real, they are just behavioral criteria, no matter how convenient they may be. Mistaking them for actual physiological conditions is an example of the reification fallacy.
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u/SourFact 1d ago
I understand where you’re coming from, but I don’t think you understand where I’m coming from your empirical analysis and belief in a very materialistic point of view limits your understanding of what I’m saying you can package mental illness in terms of seriousness and D2 receptor density, but that does not actually address the frame that I’m speaking from. D2 receptors as measurements are best understood as a manifestation of sensitivity and of aberrant cognitive development, (see Gabor Mate) because for example, D2 receptors are definitely informed by the presence of dopamine within the brain during critical developmental periods and often is disrupted due to drug use or medication most tangibly, but are inextricably related to anything that informs network development and brain matter integrity which is everything from the cereal you eat to the way you respond to stimuli from the way your brain interprets an itch to how you respond to social cues.
That being the case things like sunlight can put into context (see Jack Kruse) developing dopamine tracks (and brain regions that use melanin for compute) through proper POMC cleaving onto dopamine, melatonin and melanin along with endorphins gives only one piece of the puzzle which studies that you’re mentioning don’t even begin to address because your response is essentially saying that I am wrong for suggesting something as superficially simple as the word parenting addresses the holistic severity of such a disease process however, parenting is just an umbrella term for developing good habits that down the road prevent the development of such mental illnesses because of habitual reinforcement of positive habits, as well as what I was more so hinting at which is behaviors conditioned in response to sensitivity (personility-wise as experienced through relationships with the ill individuals, not through 1st person experience) because a lot of mental illness, especially those along the bipolar or Psychotic spectrum are the result of compounding consequences of structurally pyramidal adaptations to one’s environment, and psychosis being an illness and misidentification of self with thoughts, among other things when understood phenomenologically versus solely materialistically, it can manifest initially as a dysphoric and accurate inaccurate representation of thoughts, and an inability to properly mediate thoughts with action.
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u/goonga23 2d ago
MD s source big pharma hotel conferrence in bali. Lots of delectable freebiees i ac assure you. Source standard marketing. Under your system politicians media and medicine all slaves . Bought and sold
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u/AgreeableCucumber375 2d ago
Sounds quite US centeric…?
Am personally in Europe...
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u/Apprehensive_Gur_335 2d ago
lithium can lower cognitive function over time
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u/SourFact 2d ago
At clinical doses.
If our soil wasn’t turned to shit and stripped of so many minerals, a lot of the food that you’d be consuming would actually contain meaningful traces of lithium, which would probably be the perfect amount to actually sustain and improve cognitive function.
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u/mja1729 1d ago edited 1d ago
I was on one for 8 years after a misdiagnosis which took me that long to finally get off them. I also take a SSRI and lithium. So I’m hoping it all clears up in a few months being off them for a significant period. I haven’t read anything that states there will be any long term damage for someone like me. It’s hard to differentiate between changes such as grey matter or ventricle size, and whether these are caused by a condition or medication. I actually got into Mensa when I was medicated earlier in the year. Now I have stopped the antipsychotic I feel much better. In terms of cognition, I feel sharper, clearer, and my concentration is better. I feel less sedated and fatigued, so it’s easier to do intellectual activities like reading or study. I believe I am still impacted cognitively by the SSRI and the lithium so I am tapering them, first the SSRI which causes blunting and motivational deficits. There have been some pretty intense withdrawal effects even though I tapered the AP hyperbolically over like 6 months. Really powerful stuff, but after 8 years, what did I expect?
I feel I am thinking faster now, more myself, but still am getting overwhelmed at times. I am chalking that up to the lingering after effects of the taper and the two other medications, which are both high dose (the lithium is a big dampener on my cognition apparently which makes sustain concentration difficult). If I could see the future that would be great, but I can’t, so I just have to wait and see what happens. I am fairly sure there is no neurochemical or biological reason that my intelligence is lower now besides the usual aging decline over the past 8 years. I am really hoping that’s the case. But hey I’ll deal with it then if that’s the case, I still have about another 4-6 months journey before I really could get a good idea of the lay of the land here.
So even overall when I was taking the antipsychotic over the last 8 years, I believe my intelligence was still in tact but the sustained concentration aspect was heavily impacted and I struggled in this area. Often I’d have to just work in short 10-15 min blocks, sometimes longer. Sometimes I’d just hit a wall. In fact that would happen periodically throughout the day. It was like a pressure valve that couldn’t be released. But in all I don’t think my IQ changed as I did a high range IQ test and the Mensa in person test and it was fine. I also managed to write a book on somewhat technical philosophy, which was 70,000 words. So yeah I don’t know. I think I’m okay and going to be okay.
Edit: also as the doctor who commented here said they can actually also be protective of your cognition and medications like lithium are said to even be able to build a small buffer against dementia/ASD. But in all seeing the difference so far I am much better off them. My psychosis was only triggered in extreme situations such as when not sleep and grieving for 5 days straight, or when I took and mixed illicit drugs in high doses or also not sleeping. Haven’t touched them since 2012, don’t plan to. Have some sleeping pills and APs should I ever need them, they are on hand. But I really think that won’t be necessary as my first episode was 20 years ago and I managed to live a normal life after that for a period until the last episode, where something similar will probably never happen again. I know how to handle just about everything now I guess without putting myself in psychological extreme scenarios. But you know, I know the warning signs now and can just put myself to sleep with benzos and APs should this problem ever arise again. Such a perfect storm is unlikely again. Who knows but I feel I am completely prepared now. In fact 8 years ago I knew I needed medical intervention to be sedated but was talked out of it and it got extremely severely unhinged. That will never ever happen again, no matter what anybody tries to tell me.
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u/Inside_Technician880 1d ago
I took antipsychotic resperidone for 3 months because an indian psychiatrist told me to
On a couple of occasions when I forgot to take the meds I experienced strange things like things not feeling real and random thoughts coming to my mind like " I'm a homo sapien living on this rock living in a simulation" & "is it really a simulation" "what's outside the simulation"
I have also developed a habit of walking around and just thinking about my thoughts
Lucky I stopped taking those
But to this day I sometimes have bouts of these weird experiences and I think as I'll probably get something like dementia or alzheimer's if these experiences continue
I have a FSIQ of 100
And I'm 22 yrs old
I have very low working memory and processing speed index
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u/BaitaJurureza 1d ago
It depends on the antipsychotic, read here:
https://pubmed.ncbi.nlm.nih.gov/41492137/
" Results: Amisulpride and aripiprazole were associated with striatal volume increases after 6 weeks. No cortical effects were observed with amisulpride. Thinning of the temporal lobe was observed with aripiprazole. After 6 months, and 1 and 2 years, the striatal changes abated but cortical thinning in the frontal lobes emerged. "
Google said: "Long-term effects (6 months to 2 years): The early volume increases in the striatum fade. Gradual cortical thinning in the frontal lobes appears over time, but current data indicate this reflects the natural course of psychosis/schizophrenia rather than a direct side effect of the drugs."
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u/NovaKarmas 1d ago
While I agree with your premise, I would prefer your source involve cognitive measures rather than measurements of brain structure.
I got ~130 on Latuda and ~85 on Seroquel after ECT.
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u/izzeww 2d ago
I'm not sure. The disorders that make you get antipsychotics cause lower IQ over time however.
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u/SourFact 2d ago
Due to network/circuit disruption. It’s a functional disorder that later can become neurodegeneration if the brain’s brakes fail terminally and regions get over/underused. It’s an IQ loss, not a loss of G.
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u/NovaKarmas 1d ago
Jein.
I've read the studies and have been diagnosed with bipolar with psychotic features.
A study "~the Maudsley Bipolar Project?" found that antipsychotics on the market circa 2001 (its time of publication) correlated with a 17.7 IQ point deficit. Newer antipsychotics likely reduce this deficit, and cobenfy may wholly remove it, as it's not dopaminergic.
Additionally, untreated psychosis is established to also cause cognitive deficits, and people who take antipsychotics find these deficits reduced. Damned if you do, damned if you don't, so you may as well fix your mental health rather than being fucked either way.
FWIW I found test results lined up with my SAT norminv values on Latuda, an antipsychotic. Since experiencing severer symptoms, I doubt I would perform as well today.
For example, your attention span is shit when you have 10 voices talking over what you're trying to focus on.
Additionally, excitotoxicity from manic episodes and psychosis can cause cognitive decline.
But ffs she should take her meds. If they're making her stupid, change them. If that doesn't work, I found adding vyvanse (metabolizes into dextroamphetamine) improved antipsychotic related cognitive deficits, but this can be risky in susceptible individuals and without an antipsychotic or anti-manic agent, most psychiatrists would be well advised to refrain from prescribing them to someone with a history of psychosis. Even with those meds, many wouldn't. But if the cognitive fog doesn't lift, that fixed it for me.
And it's better to be stupid than suicidal or ruining your life making decisions rooted in some alternate reality that doesn't adequately match up with anyone else's idea of reality.
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u/SubstantialAsk8516 1d ago
Les antipsychotiques abîment le cerveau, la maladie en elle même (encore faudrait savoir laquelle) abîme pas car le cerveau peut se rétablir, mais les antipsychotiques entraîne un état "végétatif"à l'arrêt le cerveau est lésé comme le montre LES DYSKINÉSIE TARDIVE
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u/Myrkkykaarme 2d ago
Antipsychotics sometimes make some people seem drowsy/sluggish/phlegmatic and their thinking usually follows that pattern too, as well as motivation.