Researchers studied how certain drugs for depression affect thinking skills in older adults whose depression did not respond to usual treatments. The study included adults aged 60 and older from medical centers in the US and Canada.
Patients were assigned to different treatment plans: adding aripiprazole or bupropion to their current antidepressants, or switching to bupropion alone. In a second step, some patients either started lithium or switched to nortriptyline. Cognitive tests measured thinking skills like memory, attention, and the ability to control impulses.
After 10 weeks of treatment, overall thinking ability improved, but there was no clear difference among the different drug plans. However, adding aripiprazole helped with impulse control, showing a small but significant improvement.
Switching to nortriptyline also improved impulse control, while adding lithium did not. Changes in thinking skills were not linked to how much depression symptoms improved. The side effects were similar among treatments, but adding bupropion caused more falls.
This study suggests that adding aripiprazole or switching to nortriptyline can modestly improve some cognitive functions in older adults with hard-to-treat depression.
The findings provide reassurance about using these options in older patients. The study did not include a placebo group and mainly involved adults under 70, which may limit applying the results more broadly.
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