Neurológia pre prax 4/2018

Pharmacotherapy of cognitive dysfunction in depressive disorder

Cognitive dysfunction frequently occurs in acute depression and can persist into remission. Cognitive impairments impacts on patient functioning and negatively influence ability to perform adequately at work. As evidenced by the results of numerous studies drugs with anticholinergic effect (e.g. tricyclic antidepressants) may adversly affect cognitive functions. The most frequently prescribed antidepressants, selective serotonin reuptake inhibitors may improve cognitivy dysfunction in depression. Agents also including a noradrenergic component such as selective serotonin and noradrenaline reuptake inhibitorts appear to be more effective in respect to cognitive functions compared to SSRI treatment. Based on the available data, the new multimodal antidepressant vortioxetine may have a specific pro-cognitive effect. Many other compounds are under investigation including stimulants, compounds acting on glutamatergic and cholinergic systems, compounds showing anti-inflammatory and antioxidant properties, nutraceutics. However, current evidence is not sufficeint to widely recommend the use of these agents in the treatment of cognitive dysfunction in depressive disorder.

Keywords: cognitive dysfunction, depressive disorder, antidepressants, augmentation, adjuvant treatment