This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.
Major depressive disorder (MDD) is a common condition that often includes cognitive dysfunction. A systematic review of studies was conducted, and a feasibility assessment was carried out to assess the relative effect of antidepressants on cognitive dysfunction in MDD. MEDLINE®, Embase®, Cochrane, CDSR, PsychINFO® databases, clinical trial registries, and relevant conference abstracts were searched for randomised controlled trials (RCTs) assessing antidepressants and/or placebo from database inception date to 13 November 2014. Network meta-analyses (NMA) between different antidepressants were conducted using a random effects model. The database search retrieved 11,337 citations of which 72 RCTs from 103 publications met the inclusion criteria. The review identified 86 cognitive scales used to assess antidepressants' effect on cognitive functioning. The Digit Symbol Substitution Test (DSST), which targets multiple domains of cognition and is recognised as being sensitive to change, was used across 12 of the included RCTs, allowing for a network of evidence to be generated. The interventions assessed included selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and other non-SSRI/SNRI antidepressants. NMA revealed that vortioxetine was the only antidepressant showing a statistically significant effect versus placebo in improving cognitive dysfunction, as assessed by DSST, in MDD patients. Vortioxetine was also either numerically or statistically more efficacious on DSST than other included antidepressants, with statistically significant differences versus escitalopram and nortriptyline. The findings of this study support the effect of vortioxetine in improving cognitive function in MDD patients.