Cognitive and psychomotor effects of three months of escitalopram treatment in elderly patients with major depressive disorder

- Psychomotor retardation is a core symptom in geriatric depression.
- Three months of treatment with escitalopram 5-20 mg is beneficial for mood.
- It appears lacking psychomotor or cognitive effects.
- There was a trend of differential effects in psychomotor and cognitive function.
- Moderate mood effects of SSRI precede presumed slow or limited effects on PR.

BackgroundAlthough psychomotor retardation (PR) and cognitive disfunctioning are essential symptoms of elderly depressed patients, the differential effect of treatment with an SSRI in the elderly on these symptoms has hardly got any attention in studies with objective experimental measures. Since effects appear relatively slower in elderly, this study evaluates the effect on cognitive and psychomotor functioning as compared to mood, on four points during a twelve week follow up of monotreatment with escitalopram.Method28 non-demented elderly unipolar depressive patients on 5-20 mg escitalopram were compared to 20 matched healthy elderly. All participants underwent a test battery containing clinical depression measures, cognitive measures of processing speed, executive function and memory, clinical ratings of PR, and objective computerized fine motor skill-tests at the start and after 2, 6 and 12 weeks. Statistical analysis consisted of a General Linear Model (GLM) repeated measures multivariate analysis of variance of completers to compare the psychomotor and cognitive outcomes of the two groups.ResultsAlthough, apart from the significant mood effect, no interaction effects were found for the psychomotor and cognitive tasks, the means in general show a trend of differential effects in cognitive and psychomotor functions, with smaller effects and delayed timeframes and with presence of subgroups compared to mood effects.LimitationLonger follow up studies are necessary to evaluate differential long term effects.ConclusionIn elderly, moderate effects of SSRI treatment on mood precede slow or limited effects on cognition and psychomotor retardation.