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Cognitive remission: a novel objective for the treatment of major depression?

Bortolato, Beatrice, Miskowiak, Kamilla W., Köhler, Cristiano A., Maes, Michael, Fernandes, Brisa S., Berk, Michael and Carvalho, Andre F. 2016, Cognitive remission: a novel objective for the treatment of major depression?, BMC medicine, vol. 14, Article number: 9, pp. 1-18, doi: 10.1186/s12916-016-0560-3.

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Title Cognitive remission: a novel objective for the treatment of major depression?
Author(s) Bortolato, Beatrice
Miskowiak, Kamilla W.
Köhler, Cristiano A.
Maes, Michael
Fernandes, Brisa S.ORCID iD for Fernandes, Brisa S. orcid.org/0000-0002-3797-7582
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Carvalho, Andre F.
Journal name BMC medicine
Volume number 14
Season Article number: 9
Start page 1
End page 18
Total pages 18
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016
ISSN 1741-7015
Keyword(s) adult
antidepressive agents
attention
cognition
cognition disorders
depressive disorder, major
humans
memory
meta-analysis as topic
nootropic agents
recovery of function
remission induction
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Antidepressants
Cognitive enhancers
Erythropoietin
Lisdexamfetamine dimesylate
Major depression
Novel targets
Vortioxetine
Psychiatry
Summary 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.
Language eng
DOI 10.1186/s12916-016-0560-3
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 ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30081349

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.