title: Improvement in subjective and objective neurocognitive functions in patients with major depressive disorder: a 12-week, multicenter, randomized trial of tianeptine versus escitalopram, the CAMPION study.
abstract: Although many patients with major depressive disorder (MDD) complain of neurocognitive impairment, the effects of antidepressant medications on neurocognitive functions remain unclear. This study compares neurocognitive effects of tianeptine and escitalopram in MDD. Patients with MDD (N = 164) were randomly assigned in a 1:1 ratio to either tianeptine (37.5 mg/d) or escitalopram (10 mg/d) for 12 weeks. Outcome measures included clinical improvement, subjective cognitive impairment on memory and concentration, the Mini-Mental State Examination, the Continuous Performance Test, the Verbal Learning Test, and the Raven Progressive Matrices, assessed every 4 weeks. After 12 weeks, the tianeptine group showed significant improvement in commission errors (P = 0.002), verbal immediate memory (P < 0.0001), Mini-Mental State Examination (P < 0.0001), delayed memory (P < 0.0001), and reasoning ability (P = 0.0010), whereas the escitalopram group improved in delayed memory and reasoning ability but not in the other measures. Both groups significantly improved in subjective cognitive impairment in memory (P < 0.0001) and concentration (P < 0.0001). Mixed effects model repeated measures analyses revealed that the tianeptine group had a significant improvement in scores of commission errors (F = 6.64, P = 0.011) and verbal immediate memory (F = 4.39, P = 0.038) from baseline to 12 weeks, compared with the escitalopram group, after controlling for age, sex, education years, baseline scores, and changes of depression severity. The treatment of MDD with tianeptine led to more improvements in neurocognitive functions, especially in commission errors and verbal immediate memory, compared with escitalopram, after controlling for changes in depression severity. Both drugs improved subjective cognitive impairment of memory and concentration.
authors: From the *Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; †Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA; ‡Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul; §Department of Psychiatry, Ilsan Paik Hospital, Inje University School of Medicine, Ilsan; ∥Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital; ¶Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine; and #Department of Psychiatry, Konkuk University School of Medicine, Seoul, South Korea.
authors: Hong Jin
authors: HJ
authors: Jeon
authors: Jong-Min
authors: JM
authors: Woo
authors: Seung-Hwan
authors: SH
authors: Lee
authors: Eui-Joong
authors: EJ
authors: Kim
authors: Seockhoon
authors: S
authors: Chung
authors: Jee Hyun
authors: JH
authors: Ha
authors: Maurizio
authors: M
authors: Fava
authors: David
authors: D
authors: Mischoulon
authors: Ji-Hae
authors: JH
authors: Kim
authors: Jung-Yoon
authors: JY
authors: Heo
authors: Bum-Hee
authors: BH
authors: Yu
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000494:pharmacology / Q000627:therapeutic use; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D013841:Thiazepines / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors; D013841:Thiazepines; C050504:tianeptine