Effects of open-label transdermal nicotine antidepressant augmentation on affective symptoms and executive function in late-life depression.

Autor: Andrews P; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Vega JN; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Szymkowicz SM; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Newhouse P; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA., Tyndale R; Departments of Pharmacology, Toxicology, and Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto, ON, Canada., Elson D; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Kang H; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA., Siddiqi S; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Tyner EB; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Mather K; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA., Gunning FM; Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, USA., Taylor WD; Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA. Electronic address: warren.d.taylor@vumc.org.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Oct 01; Vol. 362, pp. 416-424. Date of Electronic Publication: 2024 Jul 14.
DOI: 10.1016/j.jad.2024.07.025
Abstrakt: Background: Late-life depression (LLD) is characterized by a poor response to antidepressant medications and diminished cognitive performance, particularly in executive functioning. There is currently no accepted pharmacotherapy for LLD that effectively treats both mood and cognitive symptoms. This study investigated whether transdermal nicotine augmentation of standard antidepressant medications benefitted mood and cognitive symptoms in LLD.
Methods: Nonsmoking participants aged 60 years or older with unremitted LLD on stable SSRI or SNRI medications (N = 29) received transdermal nicotine patches up to a 21 mg daily dose over 12 weeks. Clinical measures assessed depression severity, secondary affective symptoms, and cognitive performance. Nicotine metabolite concentrations were obtained from blood samples.
Results: Depression severity significantly decreased over the trial, with a 76 % response rate and 59 % remission rate. Change in depression severity was positively associated with nicotine exposure. Participants also exhibited improvement in self-reported affective symptoms (apathy, insomnia, rumination, and generalized anxiety symptoms), negativity bias, and disability. Executive function test performance significantly improved, specifically in measures of cognitive control, as did subjective cognitive performance. Adverse events were generally mild, with 75 % of the sample tolerating the maximum dose.
Conclusion: The current study extends our previous pilot open-label trial in LLD, supporting feasibility and tolerability of transdermal nicotine patches as antidepressant augmentation. Although preliminary, this open-label study supports the potential benefit of transdermal nicotine patches for both mood and cognitive symptoms of LLD. Further research, including definitive randomized, blinded trials, is warranted to confirm these findings and explore long-term risk and benefit.
Trial Registration: The study was registered with clinicaltrials.gov (NCT04433767).
Competing Interests: Declaration of competing interest The authors report no conflicts of interests, including no conflicts with any product mentioned or concept discussed in this article.
(Published by Elsevier B.V.)
Databáze: MEDLINE
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