Cognitive Flexibility in Major Depression in the Course of Pharmacological and Psychotherapeutic Treatment
- Conditions
- Cognitive Performance in Major Depression
- Interventions
- Registration Number
- NCT00993876
- Lead Sponsor
- Zentrum für Integrative Psychiatrie
- Brief Summary
Cognitive deficits in major depression seem explicable by the well-recognized concept of impaired neuroplasticity in mood disorders. This concept initially emerged from preclinical evidence that antidepressants phosphorylate and therefore activate the cyclic AMP response element binding protein (CREB) that is essential for synaptic plasticity. Nevertheless, the question remains whether the activation of CREB by antidepressants is relevant for the remission of cognitive deficits in patients. We addressed this issue by investigating the cognitive improvement during treatment with either citalopram or reboxetine because these antidepressants are different in their capacity to increase phosphorylated CREB (pCREB). Besides the pharmacological treatment groups, another group of patients was treated exclusively with psychotherapy.
- Detailed Description
We randomly assigned forty-five depressive patients to one of three treatment groups (Citalopram, Reboxetin or interpersonal psychotherapy (IPT)). At baseline, day 7 and day 28 we assessed the severity of depression and the cognitive performance with respect to cognitive flexibility, memory and attention. We measured pCREB with an enzyme linked immuno sorbent assay (ELISA).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 45
- Diagnosed according DSM-IV criteria as suffering from major depressive disorder
- A baseline score of at least 18 in the Hamilton Depression Scale (HAMD)
- No psychopharmacological treatment at least one week prior inclusion or 3 days wash-out
- Severe depressive episode and/or psychotic depressive episode
Axis I disorder:
- Substance-related Disorders
- Psychotic Disorders
- Dementia or other cognitive Disorders
- Obsessive-Compulsive Disorders
Axis II disorder:
• Borderline Personality Disorder
Axis III disorder:
- Infectious Diseases
- Cancer
- Endocrinological Diseases
- Hematological Diseases
- Autoimmune Diseases
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description IPT interpersonal psychotherapy interpersonal psychotherapy Selective serotonin reuptake inhibitor (SSRI) citalopram citalopram Serotonin-norepinephrine reuptake inhibitor (SNRI) reboxetine reboxetine
- Primary Outcome Measures
Name Time Method cognitive performance with respect to cognitive flexibility, memory and attention 4 weeks
- Secondary Outcome Measures
Name Time Method CREB-phosphorylation in T-Lymphocytes 4 weeks
Trial Locations
- Locations (1)
Zentrum für Integrative Psychiatrie
🇩🇪Kiel, Germany