Section - Quick Takes

03. Do Antidepressants Improve Cognitive Symptoms in Late-Life Depression?

Published on August 1, 2024 Certification expiration date: August 1, 2027

Paul Zarkowski, M.D.

Clinical Associate Professor - University of Washington

Key Points

Antidepressant medication may improve cognitive symptoms, particularly memory and learning, in late-life depression, with an effect size similar to that for depressive symptoms.
Sertraline had the most consistent evidence of cognitive benefit in late-life depression, with significant improvement in at least one domain across all studies.
Despite short-term cognitive improvements with antidepressants, the presence of delayed memory impairment in late-life depression may still increase the risk of future dementia.

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Memory and Learning Improve with Antidepressants in Late-Life Depression

A recent systematic review and meta-analysis in the American Journal of Psychiatry investigated the effectiveness of antidepressant medication for cognitive symptoms in adults 50 or older with late-life depression. The authors found that 13 of 19 studies showed improvement in at least one cognitive test, with memory and learning or delayed recall showing improvement in 9 of 16 studies.

The meta-analysis combined five studies and found a significant improvement in memory and learning with an effect size of 0.254, similar to the efficacy value commonly reported in industry clinical trials for major depressive disorder.

Association Between Improvement in Depressive and Cognitive Symptoms

Interestingly, 7 of 10 studies showed an association between response in cognitive and depressive symptoms. Four studies demonstrated this effect at a group level, with greater cognitive improvement in participants who responded or remitted.

Two studies examined subjects individually

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04. Managing Psychosis, Agitation, and Depression in Patients with Dementia

Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate the risks and benefits of co-prescribing SSRIs and oral anticoagulants, particularly in the first month of combined use.
Describe patterns of long-term benzodiazepine use and dose escalation in adult patients, including risk factors for dose escalation.
Assess the impact of antidepressant medication on cognitive symptoms in late-life depression, particularly in the domains of memory and learning.
Compare and contrast management strategies for common neuropsychiatric syndromes in neurodegenerative diseases, including psychosis, agitation, and depression.
Analyze the efficacy, tolerability, and outcomes of different antidepressants in geriatric patients with depression based on real-world data.

Original Release Date: August 1, 2024

Expiration Date: August 1, 2027

Experts: Scott Beach, M.D., Paul Zarkowski, M.D.

Medical Editor: Flavio Guzmán, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.