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  • The International Journal of Neuropsychopharmacology, Volume 11, Issue 3
  • May 2008, pp. 381-388

Antidepressive therapy with escitalopram improves mood, cognitive symptoms, and identity memory for angry faces in elderly depressed patients

  • Egemen Savaskan (a1), Sandra E. Müller (a2), Andreas Böhringer (a3), André Schulz (a3) and Hartmut Schächinger (a3)
  • DOI:
  • Published online: 01 August 2007

Depression is a common disorder in the elderly handicapping patients with affective and cognitive symptoms. Because of their good tolerability relative to the older tricyclic compounds, selective serotonin reuptake inhibitors (SSRIs) are increasingly used for the treatment of depression in the elderly. Little is known about their effects on cognition in elderly patients. In the present 4-wk, single-centre, randomized, open-label trial we investigated the antidepressive effects of escitalopram, an SSRI, in 18 elderly depressed patients [mean age (±s.e.m.) 76.2±1.8 yr] compared to 22 healthy age-matched controls (mean age 76.9±1.8 yr). Affective and cognitive symptoms were assessed using the Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), and a face portrait recognition test to assess memory for happy and angry faces. Depressed patients prior to treatment had markedly reduced memory performance. Treatment with escitalopram improved affective and cognitive symptoms significantly. Furthermore, escitalopram treatment improved memory for negative facial stimuli. Control subjects confirmed the well- established memory bias favouring recognition of identities acquired with happy expressions. Importantly, this bias was absent in depressed patients prior to, but also after treatment. In conclusion, escitalopram, even after a relatively short treatment period, was effective in treating depression in the elderly and may help improve cognitive performance for social stimuli.

Corresponding author
Address for correspondence: E. Savaskan, M.D., Division of Psychiatry Research and Psychogeriatric Medicine, Psychiatric University Hospital, Minervastr. 145, P.O. 1682, CH-8032 Zürich, Switzerland. Tel.: ++41 44 389 16 58Fax: ++41 44 389 14 14E-mail:
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BP Bradley , K Mogg , R Williams (1995). Implicit and explicit memory for emotion-congruent information in clinical depression and anxiety. Behaviour Research and Therapy 33, 755770.

GW Brown , TO Harris , C Hepworth , R Robinson (1994). Clinical and psychosocial origins of chronic depressive episodes II: a patient inquiry. British Journal of Psychiatry 165, 457465.

R Campbell , K Elgar , J Kuntsi , R Akers , J Terstegge , M Coleman , D Skuse (2002). The classification of fear from faces is associated with face recognition skill in women. Neuropsychologia 40, 575584.

DJA Dozois , KS Dobson (2001). Information processing and cognitive organization in unipolar depression: specifity and comorbidity issues. Journal of Abnormal Psychology 110, 236246.

P Ekman (1993). Facial expression and emotion. American Psychologist 48, 384392.

RJ Erwin , RC Gur , RE Gur , B Skotnick , M Mawhinney-Hee , J Smailis (1992). Facial emotion discrimination: task construction and behavioural findings in normal subjects. Psychiatry Research 42, 231240.

MF Folstein , SE Folstein , PR McHugh (1995). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.

RB Giesler , RA Josephs , WB Swann (1996). Self-verification in clinical depression: the desire for negative evaluation. Journal of Abnormal Psychology 105, 358368.

IH Gotlib , KL Kasch , S Traill , J Joormann , BA Arnow , SL Johnson (2004). Coherence and specifity of information-processing biases in depression and social phobia. Journal of Abnormal Psychology 113, 386398.

WW Hale (1998). Judgement of facial expressions and depression persistence. Psychiatry Research 80, 265274.

CJ Harmer , Z Bhagwagar , DI Perrett , BA Völlm , PJ Cowen , GM Goodwin (2003). Acute SSRI administration affects the processing of social cues in healthy volunteers. Neuropsychopharmacology 28, 148152.

CJ Harmer , CE Mackay , CB Reid , PJ Cowen , GM Goodwin (2006). Antidepressant drug treatment modifies the neural processing of nonconscious threat cues. Biological Psychiatry 59, 816820.

CJ Harmer , NC Shelley , PJ Cowen , GM Goodwin (2004). Increased positive versus negative affective perception and memory in healthy volunteers following selective serotonin and norepinephrine reuptake inhibition. American Journal of Psychiatry 161, 12561263.

J Joormann , IH Gotlib (2006). Is this happiness I see? Biases in the identification of emotional facial expressions in depression and social phobia. Journal of Abnormal Psychology 115, 705714.

SA Langenecker , LA Bieliauskas , LJ Rapport , J-K Zubieta , EA Wilde , S Berent (2005). Face emotion perception and executive functioning deficits in depression. Journal of Clinical and Experimental Neuropsychology 27, 320333.

JM Leppänen (2006). Emotional information processing in mood disorders: a review of behavioral and neuroimaging findings. Current Opinion in Psychiatry 19, 3439.

PM Lewinsohn , JL Steinmetz , DW Larson , J Franklin (1981). Depression-related cognitions: antecedent or consequence? Journal of Abnormal Psychology 90, 213219.

LZ McArthur , RM Baron (1983). Toward an ecological theory of social perception. Psychological Review 90, 215238.

ME McNaughton , TL Patterson , MR Irwin , I Grant (1992). The relationship of life adversity, social support, and coping to hospitalization with major depression. Journal of Nervous and Mental Disease 180, 491497.

SM Persad , J Polivy (1993). Differences between depressed and nondepressed individuals in the recognition of and response to facial emotional cues. Journal of Abnormal Psychology 102, 358368.

DS Pine , S Lissek , RG Klein , S Mannuzza , JL Moulton III, M Guardino , G Woldehawariat (2004). Face-memory and emotion: associations with major depression in children and adolescents. Journal of Child Psychology and Psychiatry 45, 11991208.

Q Rahman , GD Wilson , S Abrahams (2004). Sex, sexual orientation, and identification of positive and negative facial effect. Brain and Cognition 54, 179185.

DR Rubinow , RM Post (1992). Impaired recognition of affect in facial expression in depressed patients. Biological Psychiatry 31, 947953.

C Sánchez , KP Bøgesø , B Ebert , EH Reines , C Braestrup (2004). Escitalopram versus citalopram: the surprising role of the R-enantiomer. Psychopharmacology 174, 163176.

E Savaskan , SE Müller , A Böhringer , C Philippsen , F Müller-Spahn , H Schächinger (2007). Age determines memory for facial identity and expression. Psychogeriatrics 7, 4957.

SA Surguladze , AW Young , C Senior , G Brébion , MJ Travis , ML Phillips (2004). Recognition accuracy and response bias to happy and sad facial expressions in patients with major depression. Neuropsychology 18, 212218.

T Suslow , K Junghanns , V Arolt (2001). Detection of facial expressions of emotions in depression. Perceptual and Motor Skills 92, 857868.

PD Sweeney , K Anderson , S Bailey (1986). Attributional style in depression: a meta-analytic review. Journal of Personality and Social Psychology 50, 974991.

JF Thayer , BH Jonsen (2000). Sex differences in judgement of facial effect: a multivariate analysis of recognition errors. Scandinavian Journal of Psychology 41, 243246.

G Weniger , C Lange , E Irle (2006). Abnormal size of the amygdala predicts impaired emotional memory in major depressive disorder. Journal of Affective Disorders 94, 216229.

BE Wexler , L Levenson , S Warrenburg , LH Price (1994). Decreased perceptual sensitivity to emotion-evoking stimuli in depression. Psychiatry Research 51, 127138.

JA Yesavage , TL Brink , TL Rose , O Lum , V Huang , M Adey , O Leirer (1983). Development and validation of a geriatric depression scale: a preliminary report. Journal of Psychiatric Research 17, 3749.

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The International Journal of Neuropsychopharmacology
  • ISSN: 1461-1457
  • EISSN: 1469-5111
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