Psychiatry

33rd Annual Harvey Stancer Research Day

Memory Functioning and Antidepressant Treatment: A Randomized Controlled Trial Comparing Escitalopram and Bupropion-XL: Preliminary Report
B Bouffard, S Kennedy, J Rich, L Ravindran, R Styra, Rr McIntyre. University Health Network, York University

Memory Functioning and Antidepressant Treatment (Part One)

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Despite clinical relevance, the neuropsychological profiles of treated and untreated individuals with MDD have not been well characterized, and specific cognitive mechanisms responsible for reported cognitive dysfunction remain unclear, especially in nongeriatric depressed patients. Prior investigations have methodological limitations that fail to clarify the effect of disparate antidepressant treatment on memory functioning.

Memory Functioning and Antidepressant Treatment (Part Two)

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Purpose:

To characterize the neuropsychological profile (verbal, nonverbal, working, & spatial memory) of younger adult outpatients with recurrent unipolar nonpsychotic MDD and current MDE at baseline and after 8 weeks of antidepressant treatment (bupropion-XL or escitalopram).

Primary Outcome Variables: California Verbal Learning Test II (CVLT-II): Total Recall, Learning Slope, Recall Discriminability, Recognition Discriminability. Secondary Outcome Variable: Hamilton Rating Scale for Depression - 17-Item.

Results: Memory performance was evaluated at baseline (n=55) and post-treatment (n=33). Raw scores were transformed into T-score or standard score equivalents according to norms provided in published manuals. At baseline, all memory tests were in the clinically average range compared to published norms. Across treatment, tasks measuring visuospatial abilities improved significantly. No interactions were found by treatment type. Patients’ levels of motivation and energy improved significantly over time.

Conclusions: Memory impairment is not pathognomonic of depression. In younger, ambulatory unipolar, nonpsychotic depressed outpatients, memory ability, particularly verbal memory, is relatively preserved. Specific types of memory performance may be more amenable to pharmacotherapeutic interventions than others. Higher functioning individuals may use compensatory strategies and skills to compensate for current mood state.

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