Bupropion Normalizes Cognitive Performance in Patients With Depression

C. Thomas Gualtieri, MD; Lynda G. Johnson, PhD

Disclosures
In This Article

Introduction

Patients with mood disorders are known to have neurocognitive deficits in many, if not most, cognitive domains.[1] In a recent paper, we showed that depressed patients on modern antidepressants had, in spite of successful treatment, residual deficits in tests of effortful attention, executive function, and information processing speed.[2] Although the cognitive impairments associated with depression are improved by effective antidepressant therapy, they do not tend to normalize.[3,4,5,6]

This general rule has not been tested, however, in comparative studies of specific antidepressants. One might expect, for example, that that antidepressants with potent noradrenergic effects would be cognitive enhancers.[7,8,9,10] In contrast, antidepressants whose primary action is serotonergic would be expected to be cognitively neutral, or less likely to "normalize" cognition in depressed patients.[11,12,13,14,15,16,17]

We took the opportunity to examine this proposition in a naturalistic study of depressed patients who had been treated with 7 different modern antidepressants. We wondered whether, in a real-world situation, one could demonstrate cognitive differences among patients taking different drugs. To address the question, we took advantage of a computerized neurocognitive screening battery that could administer 7 neuropsychological tests in a short period of time and generate results with millisecond accuracy. Because the test is easy to administer, it could be given, in our clinics, to virtually every patient on antidepressants.


Readers are encouraged to respond to the author at tg@ncneuropsych.com or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication via email: pblumen@stanford.edu

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