Papakostas George I
From the Clinical Trials Network and Institute, Massachusetts General Hospital, Boston.
J Clin Psychiatry. 2015 Aug;76(8):e1046. doi: 10.4088/JCP.13086tx5c.
Cognitive functioning is a symptom of major depressive disorder (MDD) that deserves particular attention by clinicians and researchers. Despite the fact that cognitive dysfunction represents a symptom of MDD as well as a functional outcome measure, cognition has been insufficiently investigated in antidepressant trials. While, until recently, few placebo-controlled trials have measured cognition in MDD, those examples which did have consisted of older adults. Of agents tested thus far in placebo-controlled trials (citalopram, duloxetine, vortioxetine), only the latter has been studied in patients aged 18-65, and only the latter has been shown to be superior to placebo in improving measures of executive functioning and to do so across adult age groups. Both duloxetine and vortioxetine appear to result in greater improvements than placebo in immediate and delayed memory. Clinicians who wish to improve the psychosocial recovery of patients with MDD should be familiar with studies of new options for treatment.
认知功能是重度抑郁症（MDD）的一种症状，值得临床医生和研究人员特别关注。尽管认知功能障碍既是MDD的一种症状，也是一种功能结局指标，但在抗抑郁药物试验中，对认知功能的研究还不够充分。直到最近，很少有安慰剂对照试验测量MDD患者的认知功能，而且那些进行了此类测量的试验对象都是老年人。在迄今为止安慰剂对照试验中测试的药物（西酞普兰、度洛西汀、伏硫西汀）中，只有后者在18至65岁的患者中进行了研究，并且只有后者在改善执行功能指标方面被证明优于安慰剂，且在所有成年年龄组中均如此。度洛西汀和伏硫西汀在即时和延迟记忆方面似乎都比安慰剂带来更大的改善。希望改善MDD患者心理社会康复情况的临床医生应该熟悉新治疗选择的研究。
