Cognitive Dysfunction and Imipramine in Outpatient Depressives

A group of moderately depressed, nonpsychotic outpatients had impaired performance on a short-term item-recognition memory task (compared with a group of matched normal controls) without evidence of impaired speed or attention on two simpler tasks. Compared with placebo, treatment with imipramine hydrochloride in a multiple crossover design using three-week treatment periods led to improved performance on the memory task without either clinically apparent improvement in depression or significantly improved performance on the other task rather than a specific impairment of short-term memory, but the data do support the presence of cognitive dysfunction in depression, even in ambulatory patients without substantial impairments of attention or motor functioning. The results also indicate that antidepressant drugs can produce improvement in cognitive function, possibly as a forerunner of clinical improvement.