SAN FRANCISCO—Combining the cognitive enhancer memantine with the antidepressant escitalopram was more effective than escitalopram alone in easing depression and apathy in older adults with depression, according to a study presented during a poster session at the American Psychiatric Association’s annual meeting.
“Late-life depression is associated with significant cognitive impairment and suboptimal treatment response compared to depression in younger adults,” wrote poster presenter Helen Lavretsky, MD. “More efficacious treatment to improve mood, cognition, and quality of life in late-life depression are urgently needed.”
The double-blind trial randomized 97 older adults with depression to treatment with either escitalopram plus memantine or escitalopram plus placebo.
At 6 months from baseline, 35 participants remained in the memantine group, and 30 participants were in the placebo group. Daily doses in the memantine group averaged 10.5 mg of escitalopram and 19.3 mg of memantine, while the daily escitalopram dose averaged 11.7 mg in the placebo group.
Depression remission rates were 79.4% in the memantine group and 62.1% in the placebo group, which was not a statistically significant difference. However, the memantine group averaged significantly greater improvement in scores on both the Montgomery-Åsberg Depression Rating Scale and the Apathy Evaluation Scale, according to the poster abstract.
Tolerability and the number of side effects were similar between treatment groups.
“Drugs that target glutamate neuronal transmission, such as memantine, offer novel approaches to treat depression, especially in older patients with cognitive impairment,” Dr. Lavretsky wrote.
“Memantine augmentation of escitalopram in geriatric depression.” Abstract presented at: the American Psychiatric Association Annual Meeting; May 21, 2019; San Francisco, CA.