Document Detail


Change in cognitive functioning following acute antidepressant treatment in late-life depression.
MedLine Citation:
PMID:  19916207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for geriatric depression. The association of late-life depression and cognitive impairment has been well documented. However, there have been few placebo-controlled trials examining the impact of SSRIs on cognitive functioning.
DESIGN: Prepost neuropsychological (NP) data collected as part of an 8-week, double-blind, placebo-controlled trial of citalopram in depressed patients aged 75 years and older were used to examine change in cognitive functioning. Setting: University-affiliated outpatient psychiatry clinics.
PARTICIPANTS: One hundred seventy-four community-dwelling men and women aged 75 years or older with nonpsychotic unipolar depression.
MEASUREMENTS: NP assessments included mental status (Mini-Mental State Examination), psychomotor speed (Wechsler Adult Intelligence Scale-III Digit Symbol Subtest), reaction time (Choice Reaction Time), visual-spatial skill (Judgment of Line Orientation), executive functioning (Stroop Color/Word Test), and memory (Buschke Selective Reminding Test).
RESULTS: Differences in the pattern of change by treatment group depended on responder status. Citalopram nonresponders were the only group to decline on verbal learning and psychomotor speed. Citalopram responders showed significant improvement in visuospatial functioning, when compared with nonresponders in either condition, but their improvement was not greater than responders on placebo. Citalopram responders showed greater improvement on psychomotor speed than citalopram nonresponders, but their improvement was not greater than placebo responders or nonresponders.
CONCLUSIONS: Medication may have a deleterious effect on some aspects of cognition among patients aged 75 years and older who have not responded. This suggests that patients should not be maintained on a medication if they have not had an adequate response.
Authors:
Michelle E Culang; Joel R Sneed; John G Keilp; Bret R Rutherford; Gregory H Pelton; D P Devanand; Steven P Roose
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry     Volume:  17     ISSN:  1545-7214     ISO Abbreviation:  Am J Geriatr Psychiatry     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-13     Completed Date:  2010-01-28     Revised Date:  2011-12-05    
Medline Journal Info:
Nlm Unique ID:  9309609     Medline TA:  Am J Geriatr Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  881-8     Citation Subset:  IM    
Affiliation:
Department of Psychology, Queens College, City University of New York, Flushing, NY 11367, USA. michelle.culang@qc.cuny.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Citalopram / adverse effects*,  therapeutic use
Cognition / drug effects*
Depressive Disorder / drug therapy*,  psychology*
Female
Geriatric Assessment
Humans
Male
Psychomotor Performance / drug effects*
Serotonin Uptake Inhibitors / adverse effects*,  therapeutic use
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 MH075006/MH/NIMH NIH HHS; K23 MH085236-03/MH/NIMH NIH HHS; T32 MH20004/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors; 59729-33-8/Citalopram

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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