Cognitive dysfunctions in depression – underestimated symptom or new dimension?

Abstract

Cognitive deficits constitute an integral part of clinical picture of depression, but often not enough attention has been paid to these deficits, mainly because of the presumption that they are secondary to typical depressive symptoms. It is considered that cognitive impairment is one of the main causes of depressive patients' poor functioning. Cognitive deficits are observed already in the first depressive episode. They may correlate with the severity of depression, with the patient's age and level of education. They may persist regardless of the improvement of depression during treatment. Cognitive deficits in depression are divided into "cold" which are not related to emotions, and "hot" - related to emotions. The "cold" deficits are supposed not to respond to antidepressants and seem to persist even in clinical remission. Vortioxetine is a novel antidepressant with a unique mechanism of action: it acts through the serotonine reuptake inhibition, but works also as 5HT(1A) agonist, as well as partial agonist of the 5HT(1B) receptor and antagonist of the 5HT(1D), 5HT(3) and 5HT(7) receptors. In preclinical studies vortioxetine showed the normalization of serotoninergic, noradrenergic, and dopaminergic transmission, additionally through GABA-ergic and glutaminergic effects. It has antidepressive property, it proved to be efficacious in various types of depression (severe, depression with anxiety, and depression in elderly); it also proved to be efficacious in those patients who did not respond sufficiently to SSRIs and SNRIs treatment. Vortioxetine is also beneficial for cognitive functions in depressed patients.

cAMP/PKA-CREB-BDNF signaling pathway in hippocampus mediates cyclooxygenase 2-induced learning/memory deficits of rats subjected to chronic unpredictable mild stress

“…The mood disorders of depression are often accompanied by cognitive symptoms, such as deficits in learning and memory, difficulty in decisions making, and loss of cognitive flexibility [2, 3]. The increasing evidence indicates that these cognitive deficiencies may be an early episode in depression, and may hence predict the likelihood of recovery, however, its pathophysiological basis remains poorly understood [4, 5].…”

Problemy zdrowia psychicznego pacjentów opieki długoterminowej jako wyzwanie dla pielęgniarek i opiekunów

“…Zaburzenia funkcji poznawczych i związana z tym narastająca niesprawność, a w następstwie utrata samodzielności życiowej stanowi ważny problem zdrowotny populacji osób starszych, który nie znajduje dostatecznego zainteresowania wśród organizatorów polskiego systemu opieki zdrowotnej. Wielu autorów szacuje występo-wanie otępienia na poziomie 10-20% populacji po 65. roku życia [12][13][14][15]. Za główną przyczynę otępienia wśród rasy białej uznaje się chorobę Alzheimera.…”

Efficacy of vortioxetine monotherapy compared with combined therapy vortioxetine and olanzapine in the treatment of major depression – first results

“…Vortioxetine also showed statistically significant improvement in cognitive functions in depressed patients. [5] Olanzapine is an atypical antipsychotic from the MARTA group (multi acting receptor targeted agents) structurally related to clozapine with no risk of agranulocytosis. It has an affinity for several serotonin (5-HT2A, 5-HT2C, 5-HT3 and 5-HT6), dopamine (D1-5), acetylcholine (M1-5), α1-adrenergic and histamine H1 receptors.…”