Meshkat Shakila, Wu Michelle, Tassone Vanessa K, Janssen-Aguilar Reinhard, Pang Hilary, Jung Hyejung, Lou Wendy, Bhat Venkat
Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Pharmacopsychiatry. 2025 Mar;58(2):71-79. doi: 10.1055/a-2381-2061. Epub 2024 Aug 23.
The relationship between antidepressant use and class with cognition in depression is unclear. This study aimed to evaluate the association of cognition with depressive symptoms and antidepressant use (class, duration, number).
Data from the National Health and Nutrition Examination Survey were examined for cognitive function through various tests and memory issues through the Medical Conditions questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire-9.
A total of 2867 participants were included. Participants with depressive symptoms had significantly higher odds of cognitive impairment (CI) on the animal fluency test (aOR=1.89, 95% CI=1.30, 2.73, P=0.002) and Digit Symbol Substitution test (aOR=2.58, 95% CI=1.34, 4.9, P=0.007), as well as subjective memory issues (aOR=7.25, 95% CI=4.26, 12.32, P<0.001) than those without depression. There were no statistically significant associations between any of the CI categories and depressive symptoms treated with an antidepressant and antidepressant use duration. Participants who were using more than one antidepressant had significantly higher odds of subjective memory issues than those who were using one antidepressant. Specifically, users of atypical antidepressants, selective serotonin reuptake inhibitors, or tricyclic antidepressants (TCAs) had significantly higher odds of subjective memory issues in comparison to no antidepressants, with TCAs showing the largest odds (aOR=4.21, 95% CI=1.19, 14.86, P=0.028).
This study highlights the relationship between depressive symptoms, antidepressant use, and CI. Future studies should further evaluate the mechanism underlying this phenomenon.
抗抑郁药物的使用及其类别与抑郁症患者认知功能之间的关系尚不清楚。本研究旨在评估认知与抑郁症状及抗抑郁药物使用（类别、疗程、数量）之间的关联。
利用美国国家健康与营养检查调查的数据，通过各种测试评估认知功能，并通过医疗状况问卷评估记忆问题。使用患者健康问卷-9评估抑郁症状。
共纳入2867名参与者。有抑郁症状的参与者在动物流畅性测试（调整后比值比[aOR]=1.89，95%置信区间[CI]=1.30，2.73，P=0.002）、数字符号替换测试（aOR=2.58，95%CI=1.34，4.9，P=0.007）以及主观记忆问题（aOR=7.25，95%CI=4.26，12.32，P<0.001）方面出现认知障碍（CI）的几率显著高于无抑郁症状者。任何CI类别与接受抗抑郁药物治疗的抑郁症状及抗抑郁药物使用疗程之间均无统计学显著关联。使用一种以上抗抑郁药物的参与者出现主观记忆问题的几率显著高于使用一种抗抑郁药物者。具体而言，与未使用抗抑郁药物相比，使用非典型抗抑郁药、选择性5-羟色胺再摄取抑制剂或三环类抗抑郁药（TCA）的参与者出现主观记忆问题的几率显著更高，其中TCA的几率最高（aOR=4.21，95%CI=1.19，14.86，P=0.028）。
本研究凸显了抑郁症状、抗抑郁药物使用与CI之间的关系。未来研究应进一步评估这一现象背后的机制。
