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Late Breaking Abstract - Does medication exacerbate comorbidities in chronic obstructive pulmonary disease? A prevalence study of neuroleptic intake

Introduction: Brain impairment, characterized by cognitive and motor alterations, is a frequent complication of COPD (Dodd et al., 2012, Heraud et al., 2018). Studies on functional alterations have reported decreased cortical activation and increased inhibitory network activity in the brain (Mohamed-Hussein et al., 2007, Alexandre et al., 2014). Many pharmacological treatments to manage anxiety in COPD increase this brain inhibitory activity (Di Lazzaro et al., 2006). This study therefore aimed to determine the prevalence of neuroleptic intake in COPD patients. Methods: COPD patients (406: 229 men/177 women, age: 65.23±9.9 years, BMI: 26.5±6.8, FEV1 (%th.): 51.98±21.44) enrolled in a pulmonary rehabilitation program (Cliniques du Souffle in Lodeve, Osseja or Riom-Es-Montagne, France) were retrospectively included. Results: Of these patients, 194 (47.8%) used neuroleptics. Benzodiazepines were the most prescribed class (29% of the 406 patients), followed by antidepressants (13.5%), antihistamines (12%), and opioids (7%). Of the 194 patients, 107 (55%) took two or more medications simultaneously. Conclusion: This study shows that neuroleptic use is very prevalent and may be an additional factor in explaining COPD-related brain disorder (cognitive impairment, reduced central motor drive, and motor control alterations). It also strengthens the role of non-pharmacological cares such as physical activity, as it can reduce anxiousness and thus neuroleptics intake, which would help to limit COPD brain impairment.