P.2.c.015 A randomised, double-blind, placebo-controlled, active-referenced study of the multimodal antidepressant Lu AA21004 in the treatment of elderly depressed patients

Katona, Cara; Hansen, Thomas; Olsen, Christina Kurre

doi:10.1016/s0924-977x(12)70388-7

Cited by 3 publications

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“…32 In the majority of reports, there was statistically significant cognitive benefit with monotherapy* or augmentation therapy. 44,45,47,[51][52][53][54][55] As might be expected, significant benefit was reported frequently with active treatment versus placebo (7 of 8 monotherapy studies 19,25,30,34,36,39,42 ) and with active augmentation versus placebo augmentation (5 of 7 studies 44,47,51,52,55 ). Of the 3 placebo-controlled studies that did not report significant benefit, all had relatively small treatment groups.…”

Section: Descriptive Analysismentioning

confidence: 96%

“…In some studies, other psychotropic agents were tested: apomorphine, 13 lithium, 48 estrogen, 49 the serotonin-reuptake enhancer tianeptine, 24 the antipsychotics aripiprazole 54 and amisulpride, 50 the mineralocorticoid receptor modulators fludrocortisone and spironolactone, 53 the cognition-enhancing drugs galantamine 46 and donepezil, 51 the dissociative anesthetic/ N-methyl-d-aspartate antagonist ketamine, 40 and the d-amphetamine prodrug lisdexamfetamine dimesylate. 44 Assessment of cognitive function was described as a primary/coprimary assessment in 32 reports (24 monotherapy*; 8 augmentation 44,46,47,49,[51][52][53][54] ) and as a secondary assessment in 9 reports (6 monotherapy 14,20,23,36,39,40 ; 3 augmentation 45,50,55 The cognitive domains assessed included processing speed, psychomotor function, attention, verbal learning and memory, verbal fluency, visuospatial awareness, and executive function. In some of the reports, the assessment instruments used are identified as measures of one or more specific domains of cognitive function.…”

Section: Descriptive Analysismentioning

confidence: 99%

“…However, such identification was inconsistent. For example, in different studies, the Stroop test was described as a measure of executive function, 31,33,35,42,45,51 information processing speed, 22,31 or attention 31 ; similarly, DSST was described as a measure of attention, 13,25,30,32 psychomotor function, 17,20,21,42 information processing speed, 20,39 or visuospatial awareness.…”

Section: Descriptive Analysismentioning

confidence: 99%

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Cognitive Effects of Pharmacotherapy for Major Depressive Disorder

Keefe¹,

McClintock²,

Roth³

et al. 2014

J. Clin. Psychiatry

102

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Objective: Cognitive impairment frequently accompanies major depressive disorder (MDD) and can persist during remission. This review examined pharmacotherapy effects on cognitive function in MDD.Data Sources: PubMed and EMBASE searches were conducted on July 30, 2013, for English language reports of cognitive assessments following pharmacologic monotherapy or augmentation therapy in MDD.Study Selection: A total of 43 research reports were identified (31 monotherapy [8 placebo-controlled, 11 active-comparator, 12 open-label], 12 augmentation therapy [7 placebo-controlled, 5 open-label]). Data Extraction: Results reported in each publicationwere examined for open-label and placebo-or active comparator-controlled studies.Results: Studies varied widely in terms of size (median, 50 participants; interquartile range, 21-143 participants), populations examined, duration (median, 8 weeks; interquartile range, 6-12 weeks), and neurocognitive assessments used. Most individual studies reported some benefit to cognition with pharmacotherapy, but there was no pattern of response in specific domains and only 12% of individually analyzed changes favored active treatment over placebo or untreated healthy controls. Sample weighted mean effect sizes revealed that verbal memory improved with monotherapy, while the largest treatment effect with augmentation therapy was for visual memory. Conclusions:Pharmacotherapy may have benefit in reducing cognitive impairment in MDD, with augmentation therapy being a potential approach for addressing cognitive deficits that persist after monotherapy has brought about clinical response or remission. However, given the wide variability in study design and treatment duration across studies, these findings should be interpreted cautiously. More definitive research is required before firm conclusions can be reached. 2014;75(8):864-876 © Copyright 2014 Physicians Postgraduate Press, Inc. Submitted: May 31, 2013; accepted January 17, 2014. Online ahead of print: July 8, 2014 J Clin Psychiatry It is now recognized that individuals with major depressive disorder (MDD) may exhibit deficits in cognition, including cognitive inefficiency.1,2 However, of the 9 diagnostic criteria for MDD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 3 "diminished ability to think or concentrate, or indecisiveness, " is the only disturbance that is clearly cognitive in nature. Other symptoms, such as diminished energy and sleep disturbances, can also adversely affect cognitive function.Cognition may be impaired in several domains, including processing speed, psychomotor skills, attention, memory, and executive functions. The domains of memory and executive function tend to show the most severe impairment, especially in elderly people with MDD. 1 For most people with MDD, it is unclear whether cognitive impairment varies with the severity of depressive symptoms or persists during times of euthymia. The degree of correlation between the severity of cognitive impairment an...

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Section: Descriptive Analysismentioning

confidence: 96%

Section: Descriptive Analysismentioning

confidence: 99%

Section: Descriptive Analysismentioning

confidence: 99%

See 1 more Smart Citation

Cognitive Effects of Pharmacotherapy for Major Depressive Disorder

Keefe¹,

McClintock²,

Roth³

et al. 2014

J. Clin. Psychiatry

102

View full text Add to dashboard Cite

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Vortioxetine for depression in adults

Koesters

Ostuzzi

Guaiana

et al. 2017

Cochrane Database of Systematic Reviews

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The place of vortioxetine in the treatment of acute depression is unclear. Our analyses showed vortioxetine may be more effective than placebo in terms of response, remission and depressive symptoms, but the clinical relevance of these effects is uncertain. Furthermore, the quality of evidence to support these findings was generally low. In comparison to SNRIs, we found no advantage for vortioxetine. Vortioxetine was less effective than duloxetine, but fewer people reported adverse effects when treated with vortioxetine compared to duloxetine. However, these findings are uncertain and not well supported by evidence. A major limitation of the current evidence is the lack of comparisons with the SSRIs, which are usually recommended as first-line treatments for acute depression. Studies with direct comparisons to SSRIs are needed to address this gap and may be supplemented by network meta-analyses to define the role of vortioxetine in the treatment of depression.

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An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study

Ebert¹,

Miskowiak

Kloster³

et al. 2017

BMC Psychiatry

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BackgroundThe manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them.MethodsIn this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18–60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients’ close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed.ResultsKey insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients’ social relationships and patients’ ability to handle daily tasks at work and at home; (3) patients’ cognitive symptoms also impacted relationships with family members and coworkers; (4) patients’ cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery.ConclusionsTaken together, these findings highlight a negative impact of patients’ cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1523-8) contains supplementary material, which is available to authorized users.

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P.2.c.015 A randomised, double-blind, placebo-controlled, active-referenced study of the multimodal antidepressant Lu AA21004 in the treatment of elderly depressed patients

Cited by 3 publications

References 0 publications

Cognitive Effects of Pharmacotherapy for Major Depressive Disorder

Cognitive Effects of Pharmacotherapy for Major Depressive Disorder

Vortioxetine for depression in adults

An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study

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