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Cited by 275Treatment of Major DepressionDementia and Cognitive Impairment ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trial with nortriptyline and paroxetine

Nebes, Robert D., Pollock, Bruce G., Houck, Patricia R., Butters, Meryl A., Mulsant, Benoit H., Zmuda, Michelle D., Reynolds, Charles F.·2003·Journal of Psychiatric Research
DOI 10.1016/s0022-3956(02)00085-7
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Abstract

Cognitive dysfunction is common in older persons suffering from a major depression. However, the degree to which this dysfunction is reversible with successful treatment of the depression remains uncertain. The present study examined the effects that treatment (randomized double-blind design) with either an SSRI (paroxetine) or a tricyclic antidepressant (nortriptyline) had on cognition in older depressed patients. The patients' performance was compared to that of a group of normal controls of similar age and education. Patients and controls were administered measures of working memory, information-processing speed, episodic memory and attention five times over the course of a 12 week trial. At baseline, the patients performed more poorly than the elderly controls on all cognitive measures. While the patients' performance did improve over the course of their treatment, the magnitude of this improvement did not exceed that produced in the elderly controls by practice alone. The same pattern of results was evident in both intent-to-treat and responder analyses. Thus, there was no evidence that the depressed patients' cognitive performance normalized after response to antidepressant therapy. Neither the patients' age at onset nor their baseline level of cognitive functioning influenced the amount by which their performance improved over the 12 week trial. There was no difference between paroxetine and nortriptyline in the amount of cognitive change associated with treatment. The present results suggest that cognitive dysfunction persists in older depressed patients even after their mood disorder has responded to antidepressant medications.

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  • In elderly depressed patients relative to elderly control subjects, DSST decrements were about double the magnitude of 0.55.

    “In elderly depressed patients relative to elderly control subjects, Nebes et al42 reported DSST decrements of about double this magnitude and further found that performance was worse in patients with late compared with early onset of disease (P < 0.04).”

    From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [42]

  • In elderly depressed patients, DSST performance was worse in patients with late compared with early onset of disease (P < 0.04).

    “In elderly depressed patients relative to elderly control subjects, Nebes et al42 reported DSST decrements of about double this magnitude and further found that performance was worse in patients with late compared with early onset of disease (P < 0.04).”

    From Digit Symbol Substitution Test: The Case for Sensitivity Over Specificity in Neuropsychological Testing (2018) · cites this paper as [42]

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Authors
Nebes, R. D., Pollock, B. G., Houck, P. R., Butters, M. A., Mulsant, B. H., Zmuda, M. D., & Reynolds, C. F.
Affiliations
University of Pittsburgh Medical Center (US)
Corresponding author
Nebes, Robert D.
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2003-03
Volume
37
Issue
2
Pages
99-108
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/s0022-3956(02)00085-7
OpenAlex
W2130735976
Cited by
275
References
42
Citations by year
2026: 3 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 8 · 2020: 15 · 2019: 11 · 2018: 13 · 2017: 5 · 2016: 14 · 2015: 17 · 2014: 15 · 2013: 24 · 2012: 13
FWCI
6.85
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Psychiatric Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Medical Center, University of Pittsburgh
  • National Institute on Aging (AG 05-133, P50AG005133)
  • National Institute of Mental Health (MH-01684, K01MH001613, MH-52247, P30MH052247, K01MH001684, K24MH065416, MH-37869, MH-43832, MH 65416, MH-01613, R01MH037869)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive impairment, major depressive disorder, older adults, antidepressant treatment, nortriptyline, paroxetine, selective serotonin reuptake inhibitors, tricyclic antidepressants, working memory, processing speed, episodic memory, attention, cognitive recovery
MeSH terms
Aged, Antidepressive Agents, Cognition Disorders, Depressive Disorder, Female, Humans, Male, Neuropsychological Tests, Nortriptyline, Task Performance and Analysis, Treatment Outcome, Paroxetine

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