Escitalopram Shows Potential to Improve Cognitive Function, Study Finds

A recent study presented at the ECNP Conference in Milan has shown that SSRI antidepressants, particularly escitalopram, may improve certain cognitive functions such as verbal memory. Researchers found that the antidepressant was associated with a 9% reduction in a specific serotonin receptor, the 5-HT4 receptor, which was linked to improvements in cognitive performance.

The study, published in Biological Psychiatry, demonstrates the dual impact of SSRIs on both mood and cognition, potentially opening the door for new treatment strategies targeting this receptor.

Key Findings: Cognitive and Mood Improvement

Researchers from Copenhagen University Hospital scanned the brains of 90 depressed patients to measure levels of the 5-HT4 receptor, which serotonin binds to. Over the course of eight weeks, patients were treated with daily doses of escitalopram. At the end of the study, patients' mood had improved, and those with greater reductions in 5-HT4 receptor levels also showed improved cognitive function, particularly in their ability to recall words.

Serotonin and the 5-HT4 Receptor

Serotonin is widely known as a "feel-good" chemical that influences mood. However, this study concentrated on the role of one specific serotonin receptor, 5-HT4, which may be crucial in both mood regulation and cognitive improvement. The study found a correlation between reduced 5-HT4 receptor levels and improved verbal memory.

"The SSRI medication contributes to cognitive improvements alongside mood enhancements," said Vibeke Dam, lead researcher.

Future Implications for Treatment

According to the researchers, stimulating the 5-HT4 receptor may offer new ways to treat cognitive impairments, especially in depression patients who have otherwise overcome the core symptoms of their disorder. Current treatments often focus on mood rather than cognitive function, but this study points to a potential pro-cognitive target in the 5-HT4 receptor.

Real-World Applications and Next Steps

The next phase of research will involve repurposing drugs that specifically stimulate the 5-HT4 receptor, some of which are already used to treat irritable bowel syndrome. By targeting this receptor, the team hopes to further explore its pro-cognitive effects in depression.

"This work points to the possibility of stimulating this specific receptor to treat cognitive problems," said Vibe Froekjaer, co-researcher.

Expert Commentary

Professor Philip Cowen, from the University of Oxford, commented on the study, noting that the 5-HT4 receptor plays a vital role in cognitive function. He highlighted a similar finding where the drug prucalopride, originally developed for constipation, was shown to improve memory in healthy participants and those at risk of depression.

More Information:

• Title: Effect of Antidepressant Treatment on 5-HT4 Receptor Binding and Associations with Clinical Outcomes and Verbal Memory in Major Depressive Disorder
• Published By: Vibeke H. Dam et al.
• Journal: Biological Psychiatry (2024)
• DOI: 10.1016/j.biopsych.2024.08.009