Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. It is a frequent residual manifestation in depression and may persist during the remitted phase. The authors of this opinion article evaluated the effects of antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD.
According to the authors, “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 reported that vortioxetine, a multimodal antidepressant, has significant procognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction 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. According to the authors, “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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Bortolato B, Miskowiak KW, Köhler CA, Maes M, Fernandes BS, Berk M and Carvalho AF: Cognitive remission: a novel objective for the treatment of major depression?, BMC Med.14(1):9 (2016), doi: 10.1186/s12916-016-0560-3.
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http://www.ncbi.nlm.nih.gov/pubmed/26801406