EFFECTS OF ANTIDEPRESSANTS ON COGNITIVE FUNCTIONS - A REVIEW

The widespread use of antidepressants since the late 1950s and especia lly the ambulatory treatment of the majority of depressive patients ra ises the issue of the state of knowledge of the effects of these drugs on cognitive function. This review aims at synthesizing information a bout differential effects of antidepressants on cognitive function to facilitate good prescription. The first part of this review tries to s ummarize the main tasks used to explore global reactivity, attention, memory and psychomotor performances. The second part of this work pres ents the differential cognitive effects of antidepressants with a disc rimination between substances which have a sedative impact, antidepres sants with no cognitive effect, and drugs which seem to have a positiv e cognitive action. The differenciation is established for single and repeated administration, for healthy volunteers and depressed subjects . For each substance, the dose, the tasks selected and cognitive effec t are discussed and the question of the real benefit of this cognitive impact is raised. The specificity of cognitive effects of antidepress ants related to age and to the combination with alcohol are also tackl ed. Then the discussion raises the difficulty and the biases encounter ed to perform neuropsychological studies and particularly evaluation o f cognitive effects of antidepressants. Finally the conclusion of this review gives some advice tb select and prescribe antidepressants acco rding to their cognitive effects.