OBJECTIVE
To assess the impact of the overall psychopharmacological load on the clinical presentation, the level of cognitive functioning, and some features of social cognition in patients with a history of a depressive episode.
MATERIAL AND METHODS
The study included 36 patients in remission after a depressive episode, receiving stable therapy. The mean age was 31 years (18—73; SD 16.8), 17 females (47%) and 19 males. The following assessment tools were used: Hamilton Scale for Depression, Hamilton Scale for Anxiety, Abbreviated Montreal Cognitive Assessment, and Emotion Attribution Test. Doses of drugs included in the therapeutic regimens were evaluated in the appropriate equivalents.
RESULTS
Most patients had mild manifestations of depression or depression with anxiety. Indicators of cognitive performance were within reference range. The social cognition score according to the Emotion Attribution Test was below the reference. All but two patients received antidepressant therapy at an equivalent dose higher than the recommended dose. Only two patients received monotherapy. 28% of patients received antipsychotics at a dose below the average recommended dose in addition to antidepressants, 17% of patients received normothymic agents at a dose below the average recommended dose, 22% received benzodiazepine tranquilizers, and 42% received histaminergic sedatives. The cholinolytic load was moderately high in 44% of patients. No association was found between antidepressant load and clinical and cognitive parameters. The cholinolytic load did not affect the performance in cognitive tests, but reduced the ability of patients to adequately attribute emotions in the corresponding test. Patients treated with a combination of antidepressants and antipsychotics performed better in cognitive tests.
CONCLUSION
The combination of relatively high doses of antidepressants with subtherapeutic doses of antipsychotic agents has the most multifaceted effect. Moderate cholinolytic load does not affect the cognitive performance of patients, but reduces their social cognition in terms of emotion attribution in the context of social interaction.
