Evidence map›Paper›PMID 33683582›Full record

Trial reportCNS drugs2021

Cognitive Outcomes with Sequential Escitalopram Monotherapy and Adjunctive Aripiprazole Treatment in Major Depressive Disorder: A Canadian Biomarker Integration Network in Depression (CAN-BIND-1) Report.

Trisha Chakrabarty, Shane J McInerney, Ivan J Torres, Benicio N Frey, Roumen V Milev, Daniel J Müller, Susan Rotzinger, Sidney H Kennedy, Raymond W Lam, CAN-BIND Investigator Team

2 registry-linked trialsAbstract readClinical TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in CNS drugs, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01655706 phase3completednot on this map

Integrated Biological Markers for the Prediction of Treatment Response in Depression

TypeinterventionalSponsorUniversity Health Network, TorontoRan2012 to 2017Enrolled211ConditionsMajor Depressive DisorderArmsescitalopram, aripiprazole
NCT05017311 phase4recruitingnot on this mapstarted 2023, after this paper: background citation

Optimized Predictive Treatment In Medications for Unipolar Major Depression (OPTIMUM-D)

TypeinterventionalSponsorNova Scotia Health AuthorityRan2023 to 2029Enrolled400ConditionsMajor Depressive DisorderArmsEscitalopram, Brexpiprazole
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Trisha ChakrabartyDepartment of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada. trisha.chakrabarty@ubc.ca.ORCID 0000-0002-2262-8697
Shane J McInerneyDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Ivan J TorresDepartment of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
Benicio N FreyDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Roumen V MilevDepartment of Psychology, Queen's University, Kingston, ON, Canada.
Daniel J MüllerDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Susan RotzingerDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Sidney H KennedyDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Raymond W LamDepartment of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
CAN-BIND Investigator Team
University of Toronto · CAUniversity of British Columbia · CAQueen's University · CASt. Joseph’s Healthcare Hamilton · CAUniversity of British Columbia Hospital · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundCognitive deficits are detectable in major depressive disorder (MDD). The cognitive impact of antidepressants remains unclear, as does the cognitive effects of aripiprazole in MDD, a commonly used adjunct with putative pro-cognitive properties.

objectivesIn this multi-centre, open-label study, cognitive changes associated with escitalopram monotherapy and adjunctive aripiprazole were examined.

methodsAcutely depressed participants with MDD (n = 209) received 8 weeks of escitalopram. Non-responders received an additional 8 weeks of adjunctive aripiprazole (ESC-ARI, n = 88), while responders (ESC-CONT, n = 82) continued escitalopram monotherapy (n = 39 lost to attrition). ESC-ARI, ESC-CONT and matched healthy participants (n = 112) completed the Central Nervous System Vital Signs cognitive battery at baseline, 8 and 16 weeks. Linear mixed models compared participants with MDD cognitive trajectories with healthy participants.

resultsParticipants with MDD displayed poorer baseline global cognition (assessed via the Neurocognitive Index), composite memory and psychomotor speed vs healthy participants. There were no statistically significant changes in participants with MDD receiving escitalopram monotherapy from baseline to week 8 in the neurocognitive index, reaction time, complex attention, cognitive flexibility, memory or psychomotor speed. Overall symptom severity changes were not associated with cognitive changes. The ESC-CONT group displayed no significant cognitive changes from weeks 8 to 16; reaction time worsened in the ESC-ARI group (p = 0.008) from weeks 8 to 16, independent of symptom change.

conclusionsEscitalopram monotherapy in acute MDD did not result in significant cognitive improvements. We provide novel evidence that escitalopram continuation in responders does not adversely affect cognition, but adjunctive aripiprazole in escitalopram non-responders worsens reaction time. Treatments targeting cognitive dysfunction are needed in MDD. CLINICALTRIALS. GOV IDENTIFIER: NCT01655706; 2 August, 2012.

Indexed as

AdolescentAdultAntidepressive AgentsAripiprazoleBiomarkersCanadaCognitionCognitive DysfunctionDrug Therapy, CombinationEscitalopramFemaleHumansMajor Depressive DisorderMaleMiddle AgedYoung AdultAntidepressive AgentsAripiprazoleBiomarkersEscitalopram

Identifiers

PMID33683582
OpenAlexW3134994261

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.