Neuropsychological markers of antidepressant action: a secondary analysis of the ANTLER randomised controlled trial
Neuropsychological markers of antidepressant action: a secondary analysis of the ANTLER randomised controlled trial
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.
Antidepressants, cognitive neuropsychological model, depression, emotional processing, memory, recall
6592-6599
Rodriguez-Sanchez, Julie
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Lewis, Gemma
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Solmi, Francesca
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Bone, Jessica K.
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Moore, Michael
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Wiles, Nicola
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Harmer, Catherine J.
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Duffy, Larisa
68ab154c-9825-44ad-8385-b3dcadf30651
Lewis, Glyn
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2 February 2023
Rodriguez-Sanchez, Julie
1297b351-e96e-456f-b13f-50f31fd9e7f6
Lewis, Gemma
736f9361-ca4d-4347-bc75-18d21fda5052
Solmi, Francesca
b0b3a9e0-c3e2-4c94-a991-86d2240a2ece
Bone, Jessica K.
bbf3f111-1e9e-44e0-8d77-940bfff076ad
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Wiles, Nicola
fcec2769-de78-4b86-b9c1-eab754a02837
Harmer, Catherine J.
7e82f86d-667d-47f4-a459-687e91b53b73
Duffy, Larisa
68ab154c-9825-44ad-8385-b3dcadf30651
Lewis, Glyn
64d33857-c138-4d24-96c9-f91219acce46
Rodriguez-Sanchez, Julie, Lewis, Gemma, Solmi, Francesca, Bone, Jessica K., Moore, Michael, Wiles, Nicola, Harmer, Catherine J., Duffy, Larisa and Lewis, Glyn
(2023)
Neuropsychological markers of antidepressant action: a secondary analysis of the ANTLER randomised controlled trial.
Psychological Medicine, 53 (14), .
(doi:10.1017/S0033291722003981).
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.
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ANTLER_secondary_analysis_REVISED
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Accepted/In Press date: 21 December 2022
e-pub ahead of print date: 2 February 2023
Published date: 2 February 2023
Additional Information:
Funding Information:
This work was supported by the National Institute for Health Research (HTA Programme 13/115/48), the Medical Research Council (JRS, Grant No. MR/N013867/1) and the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (NW). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© The Author(s), 2023.
Keywords:
Antidepressants, cognitive neuropsychological model, depression, emotional processing, memory, recall
Identifiers
Local EPrints ID: 474157
URI: http://eprints.soton.ac.uk/id/eprint/474157
ISSN: 0033-2917
PURE UUID: 1fe612b5-619c-41aa-8aa5-0a3f52ee03d0
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Date deposited: 14 Feb 2023 17:43
Last modified: 17 Mar 2024 03:01
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Contributors
Author:
Julie Rodriguez-Sanchez
Author:
Gemma Lewis
Author:
Francesca Solmi
Author:
Jessica K. Bone
Author:
Nicola Wiles
Author:
Catherine J. Harmer
Author:
Larisa Duffy
Author:
Glyn Lewis
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