Objective:

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.

Sources:

• Psychological Medicine