Bupropion Normalizes Cognitive Performance in Patients With Depression

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

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In This Article

Methods & Materials

The subjects of this investigation were outpatients at the NC Neuropsychiatry Clinics in Chapel Hill and Charlotte, North Carolina, age 18-65 years, with the diagnosis of major depressive disorder, unipolar, nonpsychotic. The subjects were all in good health, with no concomitant neurocognitive disorders (eg, attention-deficit disorder, learning disability, chronic pain, mild cognitive impairment) and no comorbid psychiatric diagnoses. They were on no concomitant medications. Subjects were selected for inclusion in this investigation if antidepressant treatment led to optimal clinical response, in the opinion of the treating clinician, and if the patient had been discharged to routine, quarterly follow-up. All patients had to have been on a stable dose of drug for at least 4 weeks.

A search of a database of patients who had been tested with the CNS Vital Signs battery at the North Carolina Neuropsychiatry Clinics yielded no fewer than 541 patients who had been tested while on antidepressants. Eliminating patients who did not meet the above criteria, and matching patients as closely as possible for 3 equal groups on the basis of medication, age, race, and gender yielded a final sample of 81 patients (bupropion, 27; venlafaxine, 27; selective serotonin reuptake inhibitors [SSRIs], 27).

Twenty-seven controls were randomly selected from the CNS Vital Signs normal database. This database comprises individuals who are in good health with no current or past psychiatric, neurologic, or cognitive disorder, and on no current centrally active medications. The controls were matched as closely as possible for age, race, and gender. (All of the subjects, both patients and controls, were white.)

The patients' neurocognitive performance was measured on a computerized battery of tests, CNS Vital Signs (CNSVS). CNSVS is a PC-based neurocognitive screening battery that comprises 7 familiar neuropsychological tests: verbal memory (VBM); visual memory (VIM); finger tapping (FTT); symbol-digit coding (SDC); the Stroop test (ST); the shifting attention test (SAT); and the continuous performance test (CPT). The test battery is self-administered in the clinic on an ordinary PC and takes about 30 minutes to complete. CNS Vital Signs generates 5 cognitive domain scores and 1 summary score (the "neurocognition index," NCI). Group differences were assayed by MANOVA, taking as covariates patient age and gender. If significant differences between groups were detected, pairwise t tests were done to measure differences between the 3 antidepressant groups and normals.

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