Adding memantine to escitalopram boosts cognitive function in depressed elders

  • Lavretsky H & al.
  • Am J Geriatr Psychiatry
  • 22/08/2019

  • Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Adding memantine to escitalopram improved cognitive function at 12 months in older adults with major depressive disorder (MDD) and subjective memory complaints.

Why this matters

  • Geriatric depression affects up to 15% of primary care patients and has a poorer prognosis than depression experienced earlier in life.
  • Geriatric depression is often accompanied by cognitive complaints.

Study design

  • Double-blind, randomized study on patients (age, ≥60 years) with MDD and subjective memory complaints receiving escitalopram+memantine (ESC/MEM, n=48) or escitalopram+placebo (ESC/PBO, n=47).
  • Funding: NIH; the National Center for Advancing Translational Science.

Key results

  • ESC/MEM vs ESC/PBO group showed significant improvements in:
    • change in Montgomery-Åsberg Depression Rating Scale scores at 6 months (6.5; P=.01);
    • changes in clinical global impression of depression severity (12 months: 2.2; P=.01); and
    • cognitive function at 12 months (delayed recall, 4.3; P=.02; executive functioning, 5.1; P=.01; global performance score, 7.2; P=.001).
  • Drop-out rates, tolerability, and Hamilton Rating Scale for Depression (HAM-D) scores did not significantly differ between the 2 groups.
  • Depressive symptoms improved (change in HAM-D; P<.0001 at and months: style="list-style-type:circle;">
  • ESC/MEM group: −11.7, −11.8, and −9.9, respectively.
  • ESC/PBO group: −11.3, −11.1, and −12.2, respectively.

Limitations

  • Homogeneous sample.
  • High drop-out rate.

Coauthored with Chitra Ravi, MPharm