Open-trial response to antidepressant treatment in elderly patients with mixed depression and cognitive impairment

Reynolds, Charles F.; Perel, James M.; Kupfer, David J.; Zimmer, Ben; Stack, Jacqueline A.; Hoch, Carolyn C.

doi:10.1016/0165-1781(87)90069-2

Cited by 66 publications

(20 citation statements)

References 25 publications

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“…Depression is one of the most common psychiatric accompaniments of AD (affecting up to 20-30% of cases) and anti-depressant medications provide effective treatment (Reynolds et al, 1987), although there are few double blind clinical trials of the effectiveness of this treatment (Reifler, 1989).…”

Section: Other Approaches Directed At Monoaminergic Systemsmentioning

confidence: 99%

Monoamine neurons in aging and Alzheimer's disease

Palmer

DeKosky

1993

J. Neural Transmission

167

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The integrity of dopaminergic, noradrenergic and serotonergic neurons in normal aging and Alzheimer's disease is reviewed. Loss of dopaminergic innervation of the neostriatum is a prominent age-related change, which corresponds with the age-related loss of dopaminergic cell bodies from the substantia nigra. This change is regionally specific, since dopaminergic innervation of the neocortex and the neostriatum are not affected. Although there is an age-related loss of noradrenergic cell bodies from the locus coeruleus, most studies indicate normal concentrations of noradrenaline in target areas. There is also evidence for reduced serotonergic innervation of the neocortex and, less convincingly, the neostriatum. Alzheimer's disease is associated with more pronounced noradrenergic and serotonergic denervation but, unlike normal aging, dopaminergic innervation of neostriatum is intact; although dopamine neurons are probably dysfunctional in this region. Studies relating neuronal markers to the symptomatology of Alzheimer's disease indicate that dysfunction of monoamine neurons is more closely linked to non-cognitive than to cognitive changes in behavior. In addition, monoaminergic therapies have been successful in ameliorating affective and psychotic behaviors along with sleep disturbances in both Alzheimer's disease and senescence. It seems likely that monoaminergic therapies (developed as we learn more about alterations in dopamine, noradrenaline and serotonin) will continue to be necessary to treat such behavioral disturbances.

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Section: Other Approaches Directed At Monoaminergic Systemsmentioning

confidence: 99%

Monoamine neurons in aging and Alzheimer's disease

Palmer

DeKosky

1993

J. Neural Transmission

167

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“…Only a few studies have examined cognitive changes in patients with degenerative dementia or chronic neuropsychiatric disease (Greenwald et al, 1989;Reifler et al, 1989;Reynolds et al, 1987). Greenwald and colleagues (1989) studied 10 inpatients who met diagnostic criteria for depression, but were diagnosed earlier with either dementia of the Alzheimer's type or vascular dementia.…”

mentioning

confidence: 99%

A Preliminary Study of the Association Between Changes in Mood and Cognition in a Mixed Geriatric Psychiatry Sample

Benedict

Dobraski

Goldstein

1999

The Journals of Gerontology Series B: Psychological Sciences an

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The relationship between measures of mood state and cognitive function was investigated in a sample of geriatric psychiatry inpatients. All were admitted to an urban hospital with varying degrees of cognitive impairment. Patients with diminishing negative affects and depressive symptoms during the course of hospitatization improved significantly on three cognitive tests, and half of the group members were no longer impaired according to their performance on a mental status exam. Correlations between cognition and mood-scale change scores were significant on tests emphasizing spatial processing and learning. Although the effects were modest in this heterogenous sample, the data demonstrate a significant influence of changing mood state on neuropsychological test performance.

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“…Treatment of depression in patients with or without cognitive impairment may therefore have bene fi ts on cognitive functioning in this group [ 3 ] . However, positive effects on cognition in the elderly can depend on the choice of antidepressant [ 4 ] , and certain antidepressants have the potential to worsen cognition.…”

Section: Neuropsychiatric Drugs Antidepressantsmentioning

confidence: 99%

Medications and Cognition in Older Adults

Caporaso¹

2012

Handbook on the Neuropsychology of Aging and Dementia

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The elderly patient is particularly susceptible to negative effects on cognition that can arise from certain medications. This may occur whether or not pre-existing cognitive impairment is present. Medications whose primary target is the central nervous system (e.g., antidepressants, antipsychotics, sedative-hypnotics) or those which are targeted at other primary systems (e.g., cardiovascular drugs, urinary anti-spasmodics) should be considered as contributing factors in the patient with confusion or memory decline. Steps that can be taken to reduce this risk include: coordination of medical care among the patient's clinicians to avoid polypharmacy, judicious selection of appropriate medications, use of the lowest effective drug dose, and substitution of non-pharmacologic therapies whenever possible. This chapter addresses potential complications of medication use in older adults with cognitive decline.

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Open-trial response to antidepressant treatment in elderly patients with mixed depression and cognitive impairment

Cited by 66 publications

References 25 publications

Monoamine neurons in aging and Alzheimer's disease

Monoamine neurons in aging and Alzheimer's disease

A Preliminary Study of the Association Between Changes in Mood and Cognition in a Mixed Geriatric Psychiatry Sample

Medications and Cognition in Older Adults

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