Antidepressant Use and Cognitive Functioning in Older Medical Patients With Major or Minor Depression: A Prospective Cohort Study With Database Linkage
Open accessAbstract
OBJECTIVE: The long-term cognitive effect of antidepressant medications in older persons is not well understood, especially in those with minor depression and complex medical conditions. The objective of this study is to examine this relationship in older medical patients with different depression diagnoses. METHODS: 281 medical inpatients aged 65 years and older from 2 acute care hospitals in Montreal, Canada, were diagnosed as with major or minor depression or without depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. They were followed up with the Mini-Mental State Examination for cognitive function and the Hamilton Depression Rating Scale for depressive symptoms at baseline and 3, 6, and 12 months after discharge. Antidepressant medication was ascertained from a provincial prescription database and quantified as cumulative exposures over each follow-up interval. RESULTS: During the 12-month follow-up period, 1027 antidepressant prescriptions were filled. The most frequently prescribed antidepressant agents were citalopram (0.81 prescriptions per person), sertraline (0.76), and paroxetine (0.66). Antidepressant use was not associated with cognitive changes among patients with major depression or without depression but was associated with an increased Mini-Mental State Examination score in patients with minor depression (1.4 points; 95% confidence interval, 0.1-2.6), independent of change in the severity of depression symptoms, concomitant benzodiazepine or psychotropic drug use, and other potentially important confounders. CONCLUSIONS: In this cohort of older medical patients, antidepressant use for 12 months did not lead to significant cognitive impairment. The small cognitive improvement among minor depression associated with antidepressant use deserves further investigation.
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Sertraline, citalopram, or paroxetine administration were not associated with significant changes in cognitive performance in a cohort of elderly patients with major depression, whereas a beneficial effect was observed in patients with minor depression.
“On the other hand, other findings indicated that sertraline, citalopram, or paroxetine administration, were not associated with significant changes in cognitive performance in a cohort of elderly patients with major depression, whereas a beneficial effect was observed in patients with minor depression, regardless of changes in the severity of depressive symptoms and concomitant benzodiazepine or p”
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Cognitive remission: a novel objective for the treatment of major depression?
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- Authors
- Han, L., McCusker, J., Cole, M., Čapek, R., & Abrahamowicz, M.
- Affiliations
- Yale University (US)
- St Mary's Hospital Centre (CA)
- McGill University (CA)
- Corresponding author
- Han, Ling
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2011-08
- Volume
- 31
- Issue
- 4
- Pages
- 429-435
- ISSN
- 0271-0749 (ISSN-L)
- PMC
- PMC3558972
- OpenAlex
- W2089679462
- Cited by
- 21
- References
- 37
- Citations by year
- 2025: 1 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 3 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Yale University
- McGill University
- Canadian Institutes of Health Research (MOP82494, MCT-15476)
- National Institute on Aging (P30 AG21342, P30AG021342)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- antidepressants, cognitive function, older adults, major depressive disorder, minor depression, cognitive impairment, citalopram, sertraline, paroxetine, medical inpatients, Mini-Mental State Examination, benzodiazepines, psychotropic drugs
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Antidepressive Agents, Cognition Disorders, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Brief Psychiatric Rating Scale, Prospective Studies, Cohort Studies, Databases, Factual
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