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Antidepressants Fail to Improve Depression-Associated Cognitive Impairment


March 22, 2016

Cognitive impairment associated with depression did not improve with 8 weeks of antidepressant treatment, even when depression symptoms did, according to a recent study published online in The Lancet Psychiatry.

The study aimed to gauge the effect, if any, of antidepressants on cognitive impairment, which researchers called “an important aspect of depression.” The investigation included 1008 adults, aged 18 to 65 years, who experienced a depressive episode in an outpatient setting and were not currently on medication for depression.
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Participants were assessed across a range of cognitive domains and then were randomly assigned to 8 weeks of treatment with escitalopram, sertraline, or venlafaxine hydrochloride extended-release. A comparison group did not receive medication, and healthy participants served as a control group. After 8 weeks, all participants were assessed again for cognitive function.

Following antidepressant treatment, participants with impairment in the cognitive domains of attention, response inhibition, verbal memory, decision speed, and information processing showed no improvement in these impairments, although some patients experienced an improvement in depression symptoms.

“Depression is associated with impairments in higher-order cognitive functions and information processing, which persist independently of clinical symptom change with treatment,” researchers concluded.

It was noted that although the 8-week treatment period limits interpretation to acute treatment effects, it does highlight cognitive impairment as an “untargeted contributor to incomplete treatment success,” according to the study authors.—Jolynn Tumolo

Reference: Shilyansky C, Williams LM, Gyurak A, Harris A, Usherwood T, Etkin A. Effect of antidepressant treatment on cognitive impairments associated with depression: a randomised longitudinal study [published online ahead of print]. March 16, 2016. Lancet Psychiatry. doi: http://dx.doi.org/10.1016/S2215-0366(16)00012-2.

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