Executive functioning complaints and escitalopram treatment response in late-life depression

Am J Geriatr Psychiatry. 2015 May;23(5):440-5. doi: 10.1016/j.jagp.2013.11.005. Epub 2013 Nov 27.

Abstract

Objective: Executive dysfunction may play a key role in the pathophysiology of late-life depression. Executive dysfunction can be assessed with cognitive tests and subjective report of difficulties with executive skills. The present study investigated the association between subjective report of executive functioning complaints and time to escitalopram treatment response in older adults with major depressive disorder (MDD).

Methods: 100 older adults with MDD (58 with executive functioning complaints and 42 without executive functioning complaints) completed a 12-week trial of escitalopram. Treatment response over 12 weeks, as measured by repeated Hamilton Depression Rating Scale scores, was compared for adults with and without executive complaints using mixed-effects modeling.

Results: Mixed effects analysis revealed a significant group × time interaction, F(1, 523.34) = 6.00, p = 0.01. Depressed older adults who reported executive functioning complaints at baseline demonstrated a slower response to escitalopram treatment than those without executive functioning complaints.

Conclusion: Self-report of executive functioning difficulties may be a useful prognostic indicator for subsequent speed of response to antidepressant medication.

Keywords: Depression; aging; executive functioning.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care Facilities
  • Antidepressive Agents, Second-Generation / administration & dosage
  • Citalopram / administration & dosage*
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Major* / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Monitoring / methods
  • Executive Function / drug effects*
  • Female
  • Humans
  • Late Onset Disorders
  • Male
  • Middle Aged
  • Prognosis
  • Psychiatric Status Rating Scales
  • Self Report
  • Treatment Outcome

Substances

  • Antidepressive Agents, Second-Generation
  • Citalopram