DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20204498

A comparative study to assess the effect of escitalopram and amitriptyline on psychomotor functions in patients of depression

Amit V. Mohite, Baliram V. Ghodke, Patil Arun W.

Abstract


Background: Depression is a most common and widespread of all psychiatric disorders. Treatment of depression includes the use of antidepressants commonly used clinically such as tricyclic antidepressants, selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitor, and monoamine oxidase inhibitors. Certain antidepressants apart from improvement in the symptoms found to have detrimental effect on cognitive and psychomotor function. Objective of this study was to assess and to compare the effect of escitalopram and amitriptyline on cognitive and psychomotor functions

Methods: Effect of escitalopram and amitriptyline on psychomotor function was assessed by using Critical flicker fusion frequency (CFF) and Reaction time (RT) in patients of mild to moderate depression at the end of 2nd and 4th week of monotherapy.

Results: Patients in both the group have their RT remained significantly higher (p<0.001) in comparison with control and CFF remained significantly lower at the end of both the week. There was a significant rise in CFF in escitalopram group as compared to amitriptyline (p<0.001). Escitalopram showed a significant improvement in Visual reaction time (VRT), Auditory reaction time (ART) and Choice reaction time (CRT) (p<0.001) compared to amitriptyline at both the follow ups.

Conclusions: Findings of this study support the use of Selective serotonin reuptake inhibitor (SSRI) i.e. escitalopram which had shown less impairment of psychomotor function in patients of Depression as compared to amitriptyline (Tricyclic antidepressant), in special subgroups of population who operate machinery, drive vehicle or require alertness for the work.


Keywords


Reaction time, CFF, Antidepressants, Cognitive functions

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References


Battista CD. Antidepressant Agents. In: In Berrtram G. Katzung, Susan B. Masters, Anthony J . Trevor, editors. Basic & Clinical Pharmacology. 11th edition. New York: TATA McGRAW- HILL. 2009;509-26.

Mitchell AJ, Dening TR. Depression-related cognitive impairment: possibilities for its pharmacological treatment. J Aff Disord. 1996;36:79-87.

Van Ojen R, Hooijer C, Bezemer D, Jonker C, Lindeboom J, Tilburg WV. Late life depressive disorder in the community.I.The relationship between MMSE score and depression in subjects with and without psychiatric history. Br J Psych. 1995;166:311-5.

Brodaty H, Harris L, Peters K, Wilhelm K, Hickie I, Boyce P, et al. Prognosis of depression in the elderly. Br J Psych. 1993;163:589-96.

Amado-Boccara I, Gougoulis N, Poirier Littre MF, Galinowski A, Loo H. Effects of antidepressants on cognitive functions: Review of the literature. Encéphale. 1994;20:65-77.

Dewan VK, Burke WJ, Roccaforte WH, Wengel SP, Rangwani SR, Folks DG. Selective serotonin reuptake inhibitors for the treatment of depression and psychosis in dementia. New Research Program and Abstract. American Psychiatric Association 148th Annual Meeting. 1995;16:57.

Doraiswamy PM, Krishnan KR, Oxman T, Jenkyn LR, Coffey DJ, Burt T, et al Does Antidepressant therapy improve cognition in elderly Depressed patients? J Gerentol A Biol Sci Med Sci. 2003;58:1137-44.

Spring B, Gelenberg AJ, Grain R, Thompsons. Amitriptyline, Clovaxamine & cognitive functions A Placebo controlled comparision in Depressed outpatients. Psychopharmacology (Berl). 1992;108:327-32.

Jacqueline D. Memory loss in Patients treated with Fluoxetine. Ann Pharmacother. 2003;37:1800-3.

Rudorfer MV, Manji HK, Potter WZ. Comparative tolerability profiles of the newer versus older antidepressants. Drug Safety. 1994;10:18-46.

Curran HV, Lader M. The psychopharmacological effects of repeated doses of fluvoxamine, mianserine and placebo in healthy human subjects. Eur J Clin Pharmacol. 1986;29:601-07.

Haslam C, Atkison S, Brown S, Haslam RA. Perception of the impact of depression and anxiety and the medication for these condition on safety at work-place. Ocupation Environ Med. 2005;62:538-45.

Winger M, Ramaekers JG, Schmitt JA. Driving impairment in depressed patients receiving long term antidepressant treatment. Psychopharmacology 2006; 188:84.

Gandon JM, Allain H. Lack of effect of single and repeated doses of levocetirizine, a new antihistamine drug, on cognitive and psychomotor functions in healthy volunteers. Brit J Clin Pharmacol. 2002;54(1):51-8.

Manual Pharmatech. Techniques in pharmacology. Seth GS Med Coll and KEM Hosp Mumbai. 1996.

Mac Nab MW, Foltz EJ, Sweitzer J. Evaluation of signal detection theory on the effects of psychotropic drugs on critical flicker-fusion frequency in normal subjects. Psychopharmacology (Berl). 1985;85(4): 431-5.

Coffey DJ, Jenkyn LR, Coffey AK, Wells BB. Sertraline vs amitriptyline vs placebo: Effects on cognitive and motor functioning in the elderly. Neuropsychopharmacol. 1994;10:222S.

Lorist MM, Snel J. Caffine effect on perceptual and motor processes. Electroencephalogr Clin Neurophysiol. 1997;102(5):401-13.

O’Neill M, Brown VJ. Amphetamine and adenosine A2A antagonist KW-6002 enhances the effect of conditional temporal probability of stimulus in rats. Behavioral neuroscience. 2007;121(2):535-43.

Trivedi MH, Lin EH, KatonWJ. Consensus recommendation for improving adherence, self –management, and outcome in patients with depression. CNS Spectr. 2007;12:1-27.

Reddy MV, Chandrashekher CR. Prevalence of Mental and behavioral Disorders in India: Metanalysis. Ind J Psych. 1998;48:149-57.

Nandi DN, Banerjee G, Mukherjee SP, Ghosh A, Nandi PS, Nandi SP. Psychiatric morbidity of Rural Indian community. Changes over 20-year interval. Br J Psych. 2000;176:351-56.

Roger M, James F. Cognitive and psychomotor effect of antidepressants with emphasis on selective reuptake inhibitor and the depressed elderly patient. German J Psych. 1999;18;332-50.

Schrijvers D, Maas YJ, Pier MP, Madani Y, Hulstijn W, Sabbe BG. Psychomotor Changes on Major Depressive Disorder during Sertraline reatement. Neuropsyc. 2009;59(1):34-42.

Sabbe B, Van Hoof J, Hulstijn W, Zitman F. Depressive retardation and treatment with fluoxetine: assessment of the motor component. J Affective Disord. 1997;43(1):53-61.

26. Fairweather DB, Kerr JS, Harrison DA, Moon CA. Hindmarch I. A double blind comparison of the effects of fluoxetine and amitriptyline on cognitive function in elderly depressed patients. Hum Psychopharmacol. 1993;8:41-7.