title: Change in cognitive functioning in depressed older adults following treatment with sertraline or nortriptyline.
abstract: OBJECTIVE
  The aim of this study was to compare the impact of nortriptyline to sertraline on change in cognitive functioning in depressed older adults.
  
  
  METHODS
  We used pre-post neuropsychological data collected as part of a 12-week medication trial comparing sertraline to nortriptyline in the treatment of older adults with non-psychotic, unipolar major depression to examine change in cognitive functioning. Neuropsychological assessments included mental status (Mini-Mental Status Exam), psychomotor speed (Purdue Pegboard), attention (Continuous Performance Test, Trail Making Test A), executive functioning (Stroop Color/word Test, Trail Making Test B), and memory (Buschke Selective Reminding Test).
  
  
  RESULTS
  Within treatment groups, patients treated with sertraline improved only on verbal learning. This change did not depend on responder status. Between treatment groups, patients treated with sertraline improved more in verbal learning compared with patients treated with nortriptyline. Looking at change in cognition as a function of medication condition and responder status revealed that sertraline responders improved more in verbal learning compared with nortriptyline responders but not more than sertraline non-responders or nortriptyline non-responders. Nortriptyline responders were the only treatment by responder status group to show no improvement in verbal learning from baseline to endpoint.
  
  
  CONCLUSIONS
  Unexpectedly, nortriptyline responders showed no improvement in verbal learning as compared with patients treated with sertraline or nortriptyline non-responders. However, given the small sample sizes and number of statistical tests (potential for type 1 error), replication is warranted.
authors.affiliation: Graduate Center, City University of New York, New York, NY, USA. Michelle.Culang@qc.cuny.edu
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Culang-Reinlieb
authors.forename: Joel R
authors.initials: JR
authors.lastname: Sneed
authors.forename: John G
authors.initials: JG
authors.lastname: Keilp
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use*; D011597:Psychomotor Performance / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D009661:Nortriptyline; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline