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Cognitive dysfunction in depression - pathophysiology and novel targets

Carvalho,AF, Miskowiak,KK, Hyphantis,TN, Kohler,CA, Alves,GS, Bortolato,B, Sales,PM, Machado-Vieira,R, Berk,M and McIntyre,RS 2014, Cognitive dysfunction in depression - pathophysiology and novel targets, CNS Neurol Disord Drug Targets, vol. 13, no. 10, pp. 1-17.

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Title Cognitive dysfunction in depression - pathophysiology and novel targets
Author(s) Carvalho,AF
Miskowiak,KK
Hyphantis,TN
Kohler,CA
Alves,GS
Bortolato,B
Sales,PM
Machado-Vieira,R
Berk,MORCID iD for Berk,M orcid.org/0000-0002-5554-6946
McIntyre,RS
Journal name CNS Neurol Disord Drug Targets
Volume number 13
Issue number 10
Start page 1
End page 17
Publisher Bentham Science Publishers
Place of publication Bussum, Netherlands
Publication date 2014-11-30
ISSN 1871-5273
1996-3181
Summary Major depressive disorder (MDD) is associated with cognitive dysfunction encompassing several domains, including memory, executive function, processing speed and attention. Cognitive deficits persist in a significant proportion of patients even in remission, compromising psychosocial functioning and workforce performance. While monoaminergic antidepressants may improve cognitive performance in MDD, most antidepressants have limited clinical efficacy. The overarching aims of this review were: (1) to synthesize extant literature on putative biological pathways related to cognitive dysfunction in MDD and (2) to review novel neurotherapeutic targets for cognitive enhancement in MDD. We found that reciprocal and overlapping biological pathways may contribute to cognitive dysfunction in MDD, including an hyperactive hypothalamic-pituitary-adrenal axis, an increase in oxidative and nitrosative stress, inflammation (eg, enhanced production of pro-inflammatory cytokines), mitochondrial dysfunction, increased apoptosis as well as a diminished neurotrophic support. Several promising neurotherapeutic targets were identified such as minocycline, statins, anti-inflammatory compounds, N-acetylcysteine, omega-3 poliunsaturated fatty acids, erythropoietin, thiazolidinediones, glucagon-like peptide-1 analogues, S-adenosyl-l-methionine (SAMe), cocoa flavonols, creatine monohydrate and lithium. Erythropoietin and SAMe had pro-cognitive effects in randomized controlled trials (RCT) involving MDD patients. Despite having preclinical and/or preliminary evidences from trials suggesting possible efficacy as novel cognitive enhancing agents for MDD, no RCT to date was performed for most of the other therapeutic targets reviewed herein. In conclusion, multiple biological pathways are involved in cognitive dysfunction in MDD. RCTs testing genuinely novel pro-cognitive compounds for MDD are warranted.
Language eng
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, Bentham Science Publishers
Persistent URL http://hdl.handle.net/10536/DRO/DU:30068740

Document type: Journal Article
Collection: School of Psychology
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