2005 issue 2

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Volume 14, issue 2

Original article

Cognitive processes in evaluation of speed and efficacy of antidepressant treatment in depression

STANISŁAW PUŻYŃSKI1, Iwona Koszewska1, EWA HABRA1, SŁAWOMIR FORNAL1, Dorota Bzinkowska1, DOROTA GRĄDZKA1, Antoni Kalinowski1, JUSTYNA MORAWIEC-PILIPIUK1, Barbara Remberk1, Łukasz Święcicki1, Jarosław Torbiński1
1. III Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2005; 14 (2): 107-113
Keywords: affective disorders, cognitive processes, antidepressants

Abstract

Objectives. The speed of action of antidepressants was assessed in terms of their effect on cognitive processes and clinical symptoms of the depressive syndrome.

Methods. 43 patients diagnosed with depressive syndrome in the course of affective disorder were examined during antidepressant treatment. The psychological evaluation included the Vienna Battery Tests (simple reaction time, RT with choice, tests for alertness and perseveration). The patients' clinical state was assessed using the MADRS scale. In the sample under study 8 patients were identified who responded well to treatment on the 28th day of therapy, as well as subgroups receiving I or II generation antidepressants.

Results. No significant improvement of cognitive processes was found in the course ofpharmacotherapy of depression between treatment days 0 and 28. A significant reduction in depressive symptoms severity as measured by the MADRS scale was not associated with a significant improvement of cognitive processes measured using the Vienna Test Battery. Changes of cognitive functions were not an early predictor of pharmacological treatment efficacy. Negative correlation was found on day 21st between the MADRS scores and performance on the reaction time tests in the group ofpatients who demonstrated a significant improvement of their clinical state on 28th day of treatment. Lack of improvement during the first three weeks of treatment (as measured by MADRS scores) does not preclude an improvement on day 28th of therapy.

Conclusions. The psychological tests used to assess improvement of cognitive processes in the course of pharmacotherapy of depression during the first four weeks of treatment turned out to be insufficiently sensitive. Classical antidepressants did not differ from the new generation pharmaceuticals as regards their effect on cognitive processes.

Address for correspondence:
Prof. Stanisław Pużyński, II Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa