A systematic review of the effects of psychiatric medications on social cognition

Zoë Haime*, Andrew J. Watson, Nadia Crellin, Louise Marston, Eileen Joyce, Joanna Moncrieff

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

13 Citations (Scopus)
75 Downloads (Pure)


Introduction: Social cognition is an important area of mental functioning relevant to psychiatric disorders and social functioning, that may be affected by psychiatric drug treatments. The aim of this review was to investigate the effects of medications with sedative properties, on social cognition.

Method: This systematic review included experimental and neuroimaging studies investigating drug effects on social cognition. Data quality was assessed using a modified Downs and Black checklist (Trac et al. CMAJ 188: E120- E129, 2016). The review used narrative synthesis to analyse the data.

Results: 40 papers were identified for inclusion, 11 papers investigating benzodiazepine effects, and 29 investigating antipsychotic effects, on social cognition. Narrative synthesis showed that diazepam impairs healthy volunteer’s emotion recognition, with supporting neuroimaging studies showing benzodiazepines attenuate amygdala activity. Studies of antipsychotic effects on social cognition gave variable results. However, many of these studies were in patients already taking medication, and potential practice effects were identified due to short-term follow-ups.

Conclusion: Healthy volunteer studies suggest that diazepam reduces emotional processing ability. The effects of benzodiazepines on other aspects of social cognition, as well as the effects of antipsychotics, remain unclear. Interpretations of the papers in this review were limited by variability in measures, small sample sizes, and lack of randomisation. More robust studies are necessary to evaluate the impact of these medications on social cognition
Original languageEnglish
Article number597
Number of pages26
JournalBMC Psychiatry
Issue number1
Publication statusPublished - 29 Nov 2021

Bibliographical note

Funding Information:
This research was funded by North East London Foundation Trust supporting the PhD study of first author ZH.

Funding Information:
EMJ is supported by the UCLH/UCL NIHR Biomedical Research Centre.

Publisher Copyright:
© 2021, The Author(s).


  • Social cognition
  • Psychiatry
  • Antipsychotic Agents
  • Benzodiazepines
  • Medication
  • Mental Health


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