Depression-related cognitive impairment: possibilities for its pharmacological treatment
Abstract
Depression-related cognitive impairment (DRCI) is a condition which despite its initial treatment response, shows a progressive deterioration. No consistent therapeutic strategies have been proposed to combat this condition. This may be due to a reluctance to treat the cognitively impaired, a failure to recognise the deleterious prognosis or a poor understanding of the likely pathogenesis. Increasing evidence implicates the hypothalamo-pituitary-adrenal (HPA) axis as a key neurobiological determinant of the presentation and course of depression-induced cognitive decline. By utilising agents which control central glucocorticoid hyperactivity over a sustained period, whilst avoiding those agents which may compromise cognitive abilities, there exists a pharmacological strategy which may minimise the morbidity of cognitive impairment related to depressive illness.
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Persisting depressive episodes are associated with hippocampal atrophy.
“There is also evidence that persisting depressive episodes are associated with hippocampal atrophy (19), possibly as a result of impaired regulation of glucocorticoid secretion (20–21).”
From Neurocognitive Correlates of Response to Treatment in Late-Life Depression (2008) · cites this paper as [21]
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“cause depressed patients also show memory deficits (27), it can be hypothesized that ECT can reverse the atrophy of stress-vulnerable hippocampal neurons (13) via regulation of neurotrophic factors (7).”
BackgroundHarmful effects of functional hypercortisolism: a working hypothesis
Tirabassi, G., Boscaro, M., & Arnaldi, G. (2013) · Endocrine · doi:10.1007/s12020-013-0112-y · Cited by 67 · see citing works
Yehuda, R., Golier, J. A., Bierer, L. M., Mikhno, A., Pratchett, L. C., Burton, C. L., Makotkine, I., Devanand, D. P., Pradhaban, G., Harvey, P. D., et al. (2010) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2010.06.010 · Cited by 44 · see citing works
“Cortisol levels influence cognitive symptoms in several disorders, and generally, greater levels of cortisol associate with greater impairments in memory, for example, in major depression (Mitchell and Dening, 1996), Cushing's disease, (León-Carrión et al.”
Steckler, T., Rammes, G., Sauvage, M. M., van Gaalen, M. M., Weis, C., Zieglgänsberger, W., & Holsboer, F. (2001) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(00)00040-6 · Cited by 36 · see citing works
Sleep, cognition and cortisol in addison’s disease: a mechanistic relationship
Henry, M., Thomas, K. G. F., & Ross, I. L. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.694046 · Cited by 34 · see citing works
Depressive Symptoms in the Frail Elderly: Physical and Psycho-Social Correlates
Barusch, A. S., Rogers, A. T., & Abu-Bader, S. H. (1999) · The International Journal of Aging and Human Development · doi:10.2190/ex76-cnuh-lja0-jvmg · Cited by 25 · see citing works
“Cognitive Impairment Cognitive impairment is widely recognized as a feature of depression, particularly among the elderly (Beats, 1996; Beats, Sahakian, & Levy, 1996; Mitchell & Dening, 1996).”
BackgroundChang, T., Lung, F., & Yen, Y. (2014) · Psychogeriatrics · doi:10.1111/psyg.12080 · Cited by 13 · see citing works
Major Depression and Cognitive Decline After 11.5 Years: Findings from the ECA Study
Rosenblatt, A., Mehta, K. M., Romanoski, A. J., Eaton, W. W., & Lyketsos, C. G. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000100927.83451.63 · Cited by 7 · see citing works
Effect of ACEA 1021 on Neurotoxicity Induced by Dexamethasone — Initial Behavioral Study
Krasuska-Grzegorczyk, B., Komsta, Ł., & Danilczuk, Z. (2024) · Acta Poloniae Pharmaceutica - Drug Research · doi:10.32383/appdr/185546 · Cited by 1 · see citing works
Mohite, A., Ghodke, B. V., & Patil Arun, W. (2020) · International Journal of Basic & Clinical Pharmacology · doi:10.18203/2319-2003.ijbcp20204498 · Cited by 1 · see citing works
“Depression related cognitive impairment is a condition that is under-recognized, undiagnosed and undertreated.(2) Cognitive impairment ranges from deficit in short term, long term memory or alteration in decision making process and impairment of information processing.”
BackgroundLeo, D. D., & Padoani, W. (1999) · Springer eBooks · doi:10.1007/978-88-470-2149-5_8
- Authors
- Mitchell, A. J., & Dening, T. R.
- Affiliations
- Fulbourn Hospital (GB)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1996-01
- Volume
- 36
- Issue
- 3-4
- Pages
- 79-87
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2160545001
- Cited by
- 21
- References
- 93
- Citations by year
- 2024: 1 · 2021: 1 · 2020: 1 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 0.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- hypothalamic-pituitary-adrenal axis, pharmacotherapy, antidepressants
- MeSH terms
- Aged, Animals, Antidepressive Agents, Cognition Disorders, Combined Modality Therapy, Dementia, Depressive Disorder, Electroconvulsive Therapy, Glucocorticoids, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System
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