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Randomized Controlled Trial
. 2023 Oct;53(14):6592-6599.
doi: 10.1017/S0033291722003981. Epub 2023 Feb 2.

Neuropsychological markers of antidepressant action: a secondary analysis of the ANTLER randomised controlled trial

Julia Rodriguez-Sanchez  1 , Gemma Lewis  2 , Francesca Solmi  2 , Jessica K Bone  3 , Michael Moore  4 , Nicola Wiles  5 , Catherine J Harmer  6   7 , Larisa Duffy  2 , Glyn Lewis  2
Affiliations
Randomized Controlled Trial

Neuropsychological markers of antidepressant action: a secondary analysis of the ANTLER randomised controlled trial

Julia Rodriguez-Sanchez et al. Psychol Med. 2023 Oct.

Abstract

Background: Antidepressants have been proposed to act via their influence on emotional processing. We investigated the effect of discontinuing maintenance antidepressant treatment on positive and negative self-referential recall and the association between self-referential recall and risk of relapse.

Methods: The ANTLER trial was a large (N = 478) pragmatic double-blind trial investigating the clinical effectiveness of long-term antidepressant treatment for preventing relapse in primary care patients. Participants were randomised to continue their maintenance antidepressants or discontinue via a taper to placebo. We analysed memory for positive and negative personality descriptors, assessed at baseline, 12- and 52-week follow-up.

Results: The recall task was completed by 437 participants. There was no evidence of an effect of discontinuation on self-referential recall at 12 [positive recall ratio 1.00, 95% CI (0.90-1.11), p = 0.93; negative recall ratio 1.00 (0.87-1.14), p = 0.87] or 52 weeks [positive recall ratio 1.03 (0.91-1.17), p = 0.62; negative recall ratio 1.00 (0.86-1.15), p = 0.96; ratios larger than one indicate higher recall in the discontinuation group], and no evidence of an association between recall at baseline or 12 weeks and later relapse [baseline, positive hazard ratio (HR) 1.02 (0.93-1.12), p = 0.74; negative HR 1.01 (0.90-1.13), p = 0.87; 12 weeks, positive HR 0.99 (0.89-1.09), p = 0.81; negative HR 0.98 (0.84-1.14), p = 0.78; ratios larger than one indicate a higher frequency of relapse in those with higher recall].

Conclusions: We found no evidence that discontinuing long-term antidepressants altered self-referential recall or that self-referential recall was associated with risk of relapse. These findings suggest that self-referential recall is not a neuropsychological marker of antidepressant action.

Keywords: Antidepressants; cognitive neuropsychological model; depression; emotional processing; memory; recall.

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Conflict of interest statement

None.

References

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