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Forensic Updates

The Neurological Effects of Commonly Used Prescription Medications

Dr. Sam Goldstein

Complimentary Service of the Neurology, Learning and Behavior Center

REVIEW #2
The Neurological Effects of Commonly Used Prescription Medications

Neuropsychologists have traditionally focused on the impact of developmental difference, trauma, medical and mental illness upon neuropsychological test performance. However, limited attention has been accorded to the impact of prescription medications on cognitive functioning. Although the majority of individuals undergoing neuropsychological testing are receiving some type of prescribed medication, those medicines are rarely considered as mitigating factors in impacting test performance. Psychomotor functioning, concentration and memory are the most common cognitive domains negatively affected by such medications. In general, sedative, negative psychomotor and attentional impacts co-occur. It is critical for neuropsychologists to increasingly consider the role these medications may play in impacting test performance, particularly when the results of such tests are used to either prove or disprove impairments in the legal arena.

Following is a table from a recent study cited from a journal on which I sit on the Editorial Board. This table summarizes drug effects on attention, psychomotor speed and memory. A limited number of examples of each type of drug appear below the table:

From Stein, R.A. & Strickland, T.L. (1998). A review of the neuropsychological effects of commonly used prescription medications. Archives of Clinical Neuropsychology, 13, 259-284. Permission requested.

Antidepressants

  • Tricyclics (TCA) (Nardil, Noripramine, Tofranil)
  • Heterocyclic (Desyrel, Nafranil)
  • MAO Inhibitors (Eldepryl, Parnate)
  • SSRI (Paxil, Prozac, Zoloft)

Anxiolytics

  • Benzodiazepine (Dalmane, Halcion, Librium)

Stimulants (Adderall, Ritalin, Dexedrine)

Antihypertensives

  • Diuretic (Dyrenium, Esidrix)
  • ACE Inhibitor (Prinivil, Zestril)
  • Beta Blockers (Tenormin, Inderal)
  • Alpha and Calcium Blocker (Procardia, Cardizem)

The Neurology, Learning and Behavior Center provides multi-disciplinary assessment, case management and treatment services for children and adults with brain injury and dysfunction, Attention-Deficit Hyperactivity Disorder, language disorders, learning disability, developmental delay, emotional disorders and adjustment problems. The Center is dedicated to the provision of treatment services.