Cognitive and psychomotor effects of three months of escitalopram treatment in elderly patients with major depressive disorder

Beheydt, Lieve; Schrijvers, Didier; Docx, Lise; Bouckaert, Filip; Hulstijn, Wouter; Sabbe, Bernard

doi:10.1016/j.jad.2015.08.041

Cited by 14 publications

(4 citation statements)

References 69 publications

(66 reference statements)

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“…One possibility is that the observed pro-cognitive effects of SSRIs are actually mediated by other (non-1A) 5-HT receptors ( Boulougouris et al, 2008 ; Furr et al, 2012 ; Imoto et al, 2015 ), and another is that improvements in cognition in patients treated with SSRIs is an epiphenomenon of improvements in mood ( Chepenik et al, 2007 ). It is also important to note that the evidence that SSRIs improve cognition is relatively weak ( Beheydt et al, 2015 ; Knorr, 2012 ; Knorr et al, 2011 ; Siepmann et al, 2003 ) and their modest ability to address cognitive symptoms in depression is considered one of their limitations ( Popovic et al, 2015 ).…”

Section: Psychological Functions Associated With Brain 5-htmentioning

confidence: 99%

Serotonin and brain function: a tale of two receptors

2017

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Previous attempts to identify a unified theory of brain serotonin function have largely failed to achieve consensus. In this present synthesis, we integrate previous perspectives with new and older data to create a novel bipartite model centred on the view that serotonin neurotransmission enhances two distinct adaptive responses to adversity, mediated in large part by its two most prevalent and researched brain receptors: the 5-HT1A and 5-HT2A receptors. We propose that passive coping (i.e. tolerating a source of stress) is mediated by postsynaptic 5-HT1AR signalling and characterised by stress moderation. Conversely, we argue that active coping (i.e. actively addressing a source of stress) is mediated by 5-HT2AR signalling and characterised by enhanced plasticity (defined as capacity for change). We propose that 5-HT1AR-mediated stress moderation may be the brain’s default response to adversity but that an improved ability to change one’s situation and/or relationship to it via 5-HT2AR-mediated plasticity may also be important – and increasingly so as the level of adversity reaches a critical point. We propose that the 5-HT1AR pathway is enhanced by conventional 5-HT reuptake blocking antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), whereas the 5-HT2AR pathway is enhanced by 5-HT2AR-agonist psychedelics. This bipartite model purports to explain how different drugs (SSRIs and psychedelics) that modulate the serotonergic system in different ways, can achieve complementary adaptive and potentially therapeutic outcomes.

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Section: Psychological Functions Associated With Brain 5-htmentioning

confidence: 99%

Serotonin and brain function: a tale of two receptors

2017

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“…Notably, a previous meta‐analysis has substantiated the moderately favorable impact of antidepressants, 40 particularly SSRIs, on executive function among individuals with depression. Nevertheless, a study involving patients diagnosed with LLD revealed that while the administration of escitalopram for a duration of 12 weeks significantly ameliorated the depressive symptoms, it did not yield a significant improvement in executive function 41 . Consequently, it was imperative to undertake further investigation into the influence of SSRIs on executive function in LLD patients through meticulously high quality placebo‐controlled trials.…”

Section: Discussionmentioning

confidence: 99%

Executive function deficits in patients with the first episode of late‐life depression before and after SSRI treatment: A pilot fMRI study

Liu,

Li,

Pan

et al. 2024

Int J Geriat Psychiatry

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BackgroundExecutive function deficits (EFD) in late‐life depression (LLD) has been reported to be associated with antidepressant treatment resistance, increased disability, and poor quality of life. However, the underlying neutral mechanisms of EFD in patients with the first episode of LLD remains unclear.MethodsA total of 27 patients with first‐episode, drug‐naive LLD and 27 non‐depressed controls (NC) were recruited for the present research. Participants underwent the Trail Making Test, the 17‐item Hamilton depression rating scale (HAMD‐17) test, and task‐state functional magnetic resonance imaging scans under the neutral Stroop task. LLD patients' executive functions, depressive symptoms, and brain activity were examined again after 6 months of antidepressant treatment.ResultsOf the 27 LLD patients, 16 cases completed 6‐month follow‐ups. Patients in the LLD baseline group spent more time on the Trail Making Test A test than those in the NC group (p < 0.05). In the presence of an incongruency between the word color and meaning, the accuracy rate of the neutral Stroop task in the LLD baseline group was lower, and the reaction time was greater than that in the NC group, with statistically significant difference (p < 0.05). The HAMD‐17 score in the LLD follow‐up group was significantly lower than that in the LLD baseline group (p < 0.05). More activated brain regions were present in the LLD baseline group than in the NC group when performing the neutral Stroop task. Compared with the LLD baseline group, abnormal activation of relevant brains in the cingulate‐prefrontal‐parietal network of LLD patients still existed in the LLD follow‐up group.ConclusionsLLD patients engaged more brain areas than the NC group while performing the neutral Stroop task. Abnormal activation of the cingulate‐prefrontal‐parietal network could be a contributing factor to EFD in LLD.Trial registrationChiCTR, ChiCTR2100042370 (Date of registration: 21/01/2021).LimitsWe didn't enroll enough first‐episode, LLD patients, the robustness of the findings need to be confirmed by large sample clinical trials.

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“…The studies that were included in which SSRI treatment lasted 12 weeks or longer ( Barch et al, 2012 ; Beheydt et al, 2015 ; Bondareff et al, 2000 ; Brendel et al, 2018 ; Butters et al, 2000 , 2011 ; Carrière et al, 2017 ; Cassano et al, 2002 ; Choe et al, 2016 ; Del Ser et al, 2019 ; Devanand et al, 2003 ; Jorge et al, 2010 ; Leng et al, 2018 ; Lenze et al, 2020 ; Mokhber et al, 2014 ; Munro et al, 2004 , 2012 ; Newhouse et al, 2000 ; Oh et al, 2021 ; Pirker-Kees et al, 2019 ; Robinson et al, 2000 ; Rocca et al, 2005 ; Rozzini et al, 2010 ; Weintraub et al, 2010 ) were slightly more likely to find positive effects than studies reporting results of treatments of 4 weeks or shorter ( Deakin et al, 2004 ; Furlan et al, 2001 ; Kerr et al, 1992 ; Martin et al, 1989 ; O’Carroll et al, 1994 ; Savaskan et al, 2008 ) and less likely to find negative results. This could indicate that long-term SSRI use does not have a deleterious effect on brain functions related to memory.…”

Section: Discussionmentioning

confidence: 99%

The effects of selective serotonin reuptake inhibitors on memory functioning in older adults: A systematic literature review

et al. 2022

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Introduction: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to older adults. In contrast to young subjects, it is unclear whether older adults may be vulnerable to cognitive side effects. Serotonin is involved in cognitive functions (e.g. memory). It is of great importance to examine the effects of SSRIs on memory functioning in older adults. Objectives: The objective of this systematic literature review is to summarize studies in which the effects of SSRI treatment on all aspects of memory functioning in older adults are investigated. Methods: PubMed, PsycINFO, CINAHL, and Embase were searched for all studies published until 18th of October 2021. Articles were included if they fulfilled the inclusion criteria as follows: (1) study design is (randomized) controlled trial, cross-sectional, or prospective cohort study; (2) study population consists of older adults (mean age ⩾65 years), or results for this age-group are reported separately; (3) intervention is use of an SSRI; and (4) effects on performance of any memory domain are measured and clearly described. Results: The search yielded 1888 articles, of which 136 were included for the full-text review. Eventually, 40 articles were included. Most studies reported no association between SSRI use and memory functioning. The studies that found a positive association mainly investigated older adults with mental or neurological disorders (e.g. depression or stroke). A few studies found a negative association in the following subgroups: non-responders (depression), patients with frontal brain disease, and women. Conclusion: Overall, no consistent negative effects of SSRIs on memory functioning in older adults were found after SSRI treatment. Most studies reported no change in memory functioning after SSRI use. Some studies even showed an improvement in memory performance. Positive effects of SSRIs on memory functioning were especially found in older adults with mental or neurological disorders, such as subjects with depression or stroke.

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Cognitive and psychomotor effects of three months of escitalopram treatment in elderly patients with major depressive disorder

Cited by 14 publications

References 69 publications

Serotonin and brain function: a tale of two receptors

Serotonin and brain function: a tale of two receptors

Executive function deficits in patients with the first episode of late‐life depression before and after SSRI treatment: A pilot fMRI study

The effects of selective serotonin reuptake inhibitors on memory functioning in older adults: A systematic literature review

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