Effects of antidepressants on cognitive functioning of elderly patients. A review

The influence of antidepressants on cognitive performance in elderly patients has been investigated in 18 studies. More than 70 different psychological tests or batteries of tests could be identified in these studies. The tentative conclusions that can be drawn are as follows. Monoamine oxidase (MAO) inhibitors hardly influence cognitive performance. Amitriptyline, dothiepin, mianserin and trazodone impair attention and ability to concentrate. Drugs with anticholinergic properties, such as nortriptyline, maprotiline and amitriptyline, might impair aspects of memory. For nortriptyline, higher plasma concentrations correlate with greater cognitive impairment. Cognitive impairment induced by nortriptyline during treatment might not be a transient effect, but may last as long as treatment continues. Data regarding the effects of selective serotonin (5-hydroxytryptamine) reuptake inhibitors on cognitive performance in the elderly indicate no detrimental effect. A consensus on the use of instruments evaluating cognitive performance is needed to allow better comparison of future studies. As these conclusions can only be provisional, more study is needed.