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Cited by 94Treatment of Major DepressionDementia and Cognitive Impairment ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Change in Cognitive Functioning Following Acute Antidepressant Treatment in Late-Life Depression

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Culang, Michelle E., Sneed, Joel R., Keilp, John G., Rutherford, Bret R., Pelton, Gregory H., Devanand, D.P., Roose, Steven P.·2009·The American Journal of Geriatric Psychiatry
DOI 10.1097/jgp.0b013e3181b4bf4aPMC PMC3852681
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Abstract

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.

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  • This finding [cognitive worsening] is consistent with another study reporting declines in verbal learning and psychomotor speed in patients taking citalopram, and with prior epidemiological data.

    “This finding is consistent with another study reporting declines in verbal learning and psychomotor speed in patients taking citalopram34, and with prior epidemiological data35.”

    From Effect of Citalopram on Agitation in Alzheimer Disease: The CitAD Randomized Clinical Trial (2014) · cites this paper as [34]

    The Discussion reports declines in verbal learning and psychomotor speed, but specifies that citalopram non-responders were the only group to decline. The cited part of the sentence omits that important qualification. The epidemiological-data clause has a separate citation and is not assessed here. (LLM, conf=0.84)

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Metadata

Authors
Culang, M. E., Sneed, J. R., Keilp, J. G., Rutherford, B. R., Pelton, G. H., Devanand, D. P., & Roose, S. P.
Affiliations
  • Queens College, CUNY (US)
  • New York State Psychiatric Institute (US)
ORCID
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2009-10
Volume
17
Issue
10
Pages
881-888
ISSN
1064-7481 (ISSN-L)
DOI
10.1097/jgp.0b013e3181b4bf4a
PMC
PMC3852681
OpenAlex
W2108094099
Cited by
94
References
6
Citations by year
2026: 4 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 7 · 2016: 10 · 2015: 12 · 2014: 10 · 2013: 2 · 2012: 7
FWCI
3.73
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (T32MH020004, K23MH075006, K23MH085236, T32MH015144)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › 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
geriatric depression, citalopram, selective serotonin reuptake inhibitors, cognitive impairment, cognitive function, treatment response, psychomotor speed, visuospatial functioning, executive function, memory, older adults, antidepressant side effects
MeSH terms
Aged, Aged, 80 and over, Cognition, Depressive Disorder, Female, Humans, Male, Psychomotor Performance, Citalopram, Geriatric Assessment, Treatment Outcome, Selective Serotonin Reuptake Inhibitors

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