Effect of aripiprazole on promoting cognitive function and enhancing clinical efficacy in patients with first-episode depression on escitalopram: A randomized controlled trial

依西酞普兰 阿立哌唑 威斯康星卡片分类测试 重性抑郁障碍 心理学 评定量表 萧条(经济学) 哈姆德 内科学 认知 精神科 医学 精神分裂症(面向对象编程) 抗抑郁药 焦虑 发展心理学 宏观经济学 经济 神经心理学
作者
Yingtan Wang,Zhe Lu,Guanglei Xun
出处
期刊:Journal of Affective Disorders [Elsevier]
卷期号:344: 159-168 被引量:1
标识
DOI:10.1016/j.jad.2023.10.038
摘要

To explore the effect of escitalopram combined with aripiprazole on cognitive function in patients with Major Depressive Disorder (MDD), and to evaluate the clinical efficacy of the combination therapy. 70 patients with first-episode MDD were randomly divided into the study group or the control group, receiving escitalopram combined with aripiprazole (5 mg/day) or escitalopram monotherapy respectively for 8 weeks. The severity of illness was assessed by using the Hamilton Rating Scale for Depression (HAMD) at baseline, at the end of 4th and 8th week, and cognitive function was assessed by using the THINC integrated tool (THINC-it), the Wisconsin Card Sorting Test (WCST), and the Continuous Performance Test (CPT). Rating Scale for Extrapyramidal Side Effects (RSESE) was applied to assess adverse reactions. The average HAMD-17 and HAMA scores decreased over time in both the control and the study groups, but the reductions were not statistically different between two groups with the passage of time. In WCST, total number of response (TR) of the study group decreased relative to the baseline at the end of the eighth week, but the control group did not significantly change during whole eight weeks. Perseverative errors (PE) in the control group eventually decreased at the end of Week 8 compared to that at Week 4, but in the study group, it was a continuous trend of decrease. In CPT, the decrease of leakage responses (LR) in the study group was higher than that of the control group in 2-digit number, and LR of the control group was higher than that of the study group at the end of Week 8 in 4-digit number. The downtrend of LR in 4-digit number kept for the whole period in study group, while in the control group, the LR did not decrease significantly until the end of Week 8 compared to that at baseline. Escitalopram combined with a low-dose of aripiprazole, and escitalopram monotherapy could both enhance cognitive function of MDD patients, while the improvements of combination therapy might happen relatively earlier. The combined use of escitalopram and aripiprazole might be more beneficial to the domains of EF and continuous attention compared to escitalopram monotherapy. There seemed no significant differences between two treatment options in alleviating depressive and anxiety symptoms.
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