Antidepressive therapy with Escitalopram improves mood, cognitive symptoms, and identity memory for angry faces in elderly depressed patients

Abstract

Depression is a common disorder in the elderly handicapping patients with affective and cognitive symptoms. Because of their good tolerability relative to the older tricyclic compounds, selective serotonin reuptake inhibitors (SSRIs) are increasingly used for the treatment of depression in the elderly. Little is known about their effects on cognition in elderly patients. In the present 4-week, single centre, randomized, open-label trial we investigated the anti-depressive effects of escitalopram, an SSRI, in 18 elderly depressed patients (mean age ±SEM: 76.2±1.8) compared to 22 healthy age-matched controls (mean age: 76.9±1.8). Affective and cognitive symptoms were assessed using the Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), and a face portrait recognition test to assess memory for happy and angry faces. Depressed patients prior to treatment had markedly reduced memory performance. Treatment with escitalopram improved affective and cognitive symptoms significantly. Furthermore, escitalopram treatment improved memory for negative facial stimuli. Control subjects confirmed the well established memory bias favouring recognition of identities acquired with happy expression. Importantly, this bias was absent in depressed patients prior, but also after treatment. In conclusion, escitalopram, even after a relatively short treatment period, was effective in treating depression in the elderly and may help improve cognitive performance for social stimuli.

Association between CYP2C19 polymorphism and depressive symptoms

“…The results are thus consistent with the assumption that subjects who receive antidepressant treatment would presumably show higher levels of depressive symptoms than healthy subjects despite their treatment. This expectation is supported by findings in elderly depressed in-patients receiving escitalopram for 4 weeks who improved from a Geriatric Depression Scale score of on average 9.4 to an average of 4.7, which however does not match the score of that of healthy controls (average 1.2) [Savaskan et al, 2008]. Further support comes from the observation that the hippocampal volume reduction that occurs in male in-patients with depression can be partially reversed with a ''successful'' antidepressant treatment, but will still not reach the volume of healthy controls [Kronmuller et al, 2008].…”

Effects of Anodal Transcranial Direct Current Stimulation and Serotonergic Enhancement on Memory Performance in Young and Older Adults

“…Clinically, it has been demonstrated that early administration of SSRIs (in combination with physiotherapy) accelerates recovery in patients with post-stroke motor deficits (Chollet et al, 2011;Siepmann et al, 2015). A number of studies show that antidepressant therapy with SSRIs does not only improve mood but also cognitive functions and memory performance (Doraiswamy et al, 2003;Savaskan et al, 2008). However, other studies could not confirm these results.…”

Chronic Enhancement of Serotonin Facilitates Excitatory Transcranial Direct Current Stimulation-Induced Neuroplasticity

“…These findings add important information to our understanding of the mechanisms of consolidation of neuroplasticity in the human cortex. The modulatory action of SSRIs could also explain their positive effects on learning and memory in humans (Savaskan et al, 2008). In stroke and depression, reduced facilitatory and enhanced inhibitory plasticity have been described (Foy et al, 1987;Schaechter, 2004).…”