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. 2016 Jan 22;14:9.
doi: 10.1186/s12916-016-0560-3.

Cognitive Remission: A Novel Objective for the Treatment of Major Depression?

Free PMC article

Cognitive Remission: A Novel Objective for the Treatment of Major Depression?

Beatrice Bortolato et al. BMC Med. .
Free PMC article


Background: Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted phase. Cognitive deficits may also impede functional recovery, including workforce performance, in patients with MDD. The overarching aims of this opinion article are to critically evaluate the effects of available antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD.

Discussion: Conventional antidepressant drugs mitigate cognitive dysfunction in some people with MDD. However, a significant proportion of MDD patients continue to experience significant cognitive impairment. Two multicenter randomized controlled trials (RCTs) reported that vortioxetine, a multimodal antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil, galantamine, scopolamine, N-acetylcysteine, curcumin, statins, and coenzyme Q10. The management of cognitive dysfunction remains an unmet need in the treatment of MDD. However, it is hoped that the development of novel therapeutic targets will contribute to 'cognitive remission', which may aid functional recovery in MDD.

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    1. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Ann Rev Public Health. 2013;34:119–138. doi: 10.1146/annurev-publhealth-031912-114409. - DOI - PMC - PubMed
    1. Stotland NL. Recovery from depression. Psychiatr Clin North Am. 2012;35(1):37–49. doi: 10.1016/j.psc.2011.11.007. - DOI - PubMed
    1. Alonso J, Vilagut G, Adroher ND, Chatterji S, He Y, Andrade LH, et al. Disability mediates the impact of common conditions on perceived health. PLoS One. 2013;8(6) doi: 10.1371/journal.pone.0065858. - DOI - PMC - PubMed
    1. Stahl SM, Grady MM. Differences in mechanism of action between current and future antidepressants. J Clin Psychiatry. 2003;64(Suppl 13):13–17. - PubMed
    1. Lee RS, Hermens DF, Porter MA, Redoblado-Hodge MA. A meta-analysis of cognitive deficits in first-episode major depressive disorder. J Affect Disord. 2012;140(2):113–124. doi: 10.1016/j.jad.2011.10.023. - DOI - PubMed

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