To investigate the effects of prucalopride on cognitive performance in patients with remitted recurrent depression.
Approach:
Study Design: A randomized, double-blind, placebo-controlled trial involving 50 patients aged 18 to 40 years with a history of at least two episodes of major depressive disorder, who had been free of depression for at least six months.
Treatment Protocol: Participants received either prucalopride (1 mg daily for two days followed by 2 mg daily for five to eight days) or placebo for seven to 10 days.
Key Findings:
Prucalopride improved verbal learning and memory, with patients recalling more words than those on placebo.
Enhanced working-memory performance was noted, with quicker responses under cognitive load.
Greater accuracy in non-emotional cognitive tasks was observed in the prucalopride group.
Limited effects on emotional processing were found, with slower response times in facial expression recognition.
No significant differences were observed in executive function measures.
Interpretation:
Cognitive improvements were primarily in learning, processing speed, and selected cognitive performance aspects, rather than across all domains tested.
Limitations:
Small sample size and short treatment duration (seven to 10 days).
Participants predominantly female, White, and highly educated, limiting generalizability.
Patients not selected based on objective cognitive impairment.
Conclusion:
Short-term 5-HT4R agonism improved performance on multiple objective cognitive measures in individuals with remitted depression, warranting further investigation.
