DEPRESSION-RELATED COGNITIVE IMPAIRMENT - POSSIBILITIES FOR ITS PHARMACOLOGICAL TREATMENT

Depression-related cognitive impairment (DRCI) is a condition which de spite its initial treatment response, shows a progressive deterioratio n. No consistent therapeutic strategies have been proposed to combat t his condition. This may be due to a reluctance to treat the cognitivel y impaired, a failure to recognise the deleterious prognosis or a poor understanding of the likely pathogenesis. Increasing evidence implica tes the hypothalamo-pituitary-adrenal (HPA) axis as a key neurobiologi cal determinant of the presentation and course of depression-induced c ognitive decline. By utilising agents which control central glucocorti coid hyperactivity over a sustained period, whilst avoiding those agen ts which may compromise cognitive abilities, there exists a pharmacolo gical strategy which may minimise the morbidity of cognitive impairmen t related to depressive illness.