A review of the neuropsychological effects of commonly used prescription medications
Open accessAbstract
The practice of clinical neuropsychology has traditionally accorded limited attention to the impact of prescription medications on cognitive functioning. Though neuropsychologists see a wide array of patients with cerebropathologic and other organ system disease that are under pharmacotherapy, systematic attention to how these compounds potentially affect neuropsychological functioning has lagged. Psychomotor functioning, concentration, and memory are the most common cognitive domains negatively affected by such medications. In general sedative, psychomotor, and, to a lesser extent, attention/concentration effects covary and typically show tolerance with sustained drug administration. Memory effects are more resistant probably due to ongoing anticholinergic effects and the established link between the cholinergic system and memory functioning. This review covers the basic science and clinical literature addressing neuropsychological functioning both in healthy nonpatients and in patients treated with antidepressants, anxiolytics, stimulants, antihypertensives, antiepileptics and antihistamines. Critical to the understanding of the effects of these agents is the integration of multiple factors that modulate medication-induced neurocognitive effects, such as chronicity of treatment, tolerance, age, ethnicity, metabolic capacity, psychological, and neurological disorders in the patient, and the benefits of successful treatment of these disorders.
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Evidence suggests newer antidepressants may be superior to prior medication classes (e.g., tricyclics, MAOIs) in neurocognitive effects.
“Nonetheless, evidence suggests they may be superior to prior medication classes (e.g., tricyclics, MAOIs; Baune & Renger, 2014;Stein & Strickland, 1998).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Stein & Strickland, 1998
The SSRIs section says SSRIs produce smaller cognitive-performance decrements than tricyclic antidepressants. But the MAO Inhibitors section says there is insufficient research for a direct comparison with SSRIs and expects the two classes to have comparable overall cognitive effects. The claimed advantage over MAOIs is therefore not supported. (LLM, conf=0.88)
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- Authors
- Stein, R. A., & Strickland, T. L.
- Affiliations
- Harbor–UCLA Medical Center (US)
- University of California, Los Angeles (US)
- Corresponding author
- Stein, R. A.
- ORCID
- Stein, R. A.
- Venue
- Archives of Clinical Neuropsychology
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-04-01
- Volume
- 13
- Issue
- 3
- Pages
- 259-284
- ISSN
- 0887-6177 (ISSN-L)
- 1873-5843
- OpenAlex
- W2054985277
- Cited by
- 98
- References
- 146
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 8 · 2015: 5 · 2014: 2 · 2013: 2 · 2012: 3
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Clinical Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 10123)
- National Institute on Drug Abuse (DA08393)
- National Institute of General Medical Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- prescription drugs, drug-induced cognitive impairment, neuropsychological outcomes, psychomotor effects, sedation, attention and concentration, memory impairment, antidepressants, anxiolytics, stimulants, antihypertensive drugs, antiepileptic drugs, antihistamines, anticholinergic effects, cholinergic system, tolerance (pharmacology and immunology), chronic drug use, metabolic capacity
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