Effects of Celecoxib on Electroconvulsive Therapy-Induced Cognitive Impairment in Patients With Major Depressive Disorder: A Pilot, Double-Blind, Placebo-Controlled Trial
-
Nafiseh Banaha
,
Padideh Ghaeli
,
Abolghasem Yousefi
,
Valentin Artounian
,
Mohammad H. Afzali
,
Mehdi Ghasemi
Abstract
Cognitive impairment, an important side effect of electroconvulsive therapy (ECT), may be related to the release of prostaglandins in the brain. Cyclooxygenase-2 (COX-2), constitutively expressed in the CNS, has a functional role in glutamate-mediated learning and memory. The goal of this pilot, double-blind, placebo-controlled trial was to evaluate the effects of the selective COX-2 inhibitor celecoxib on the adverse cognitive effects of ECT. Twenty patients diagnosed with the major depressive disorder for which ECT was indicated as a treatment for their current episode randomly received either celecoxib (200 mg orally twice a day, a total dose of 400 mg/day) or placebo. All patients underwent the same protocol for anesthesia and ECT procedures. The patients received celecoxib or the placebo for the whole period of ECT treatment, starting the day before ECT and continuing until the sixth (last) session of ECT. The Wechsler Mental Scale-III (WMS-III), the Mini-Mental Scale Examination (MMSE), and Stroop Color test were used to assess cognition before the first session and after the first, third and sixth sessions of ECT. Hamilton rating scale for depression was also used for the assessment of depression before and after the trial. Our data showed that celecoxib group did not have significant improvement in cognition based on WMS-III or MMSE scores. There was an improvement in the Stroop Color test but not statistically significant. Our results demonstrated that although celecoxib was well tolerated in patients undergoing ECT, it did not improve related cognitive impairment. Clinical trial registration number: IRCT201201247202N2. CNS, central nervous system; COX-2, Cyclooxygenase-2; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision; ECT, electroconvulsive therapy; ECS, electroconvulsive shocks; HAM-D, Hamilton rating scale for depression; LTP, long term potentiation; MDD, major depressive disorder; MMSE, Mini-Mental State Examination; NSAIDs, nonsteroidal anti-inflammatory drugs; WMS-III, Wechsler Memory Scale-III.
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4. Sackeim HA. Memory and ECT: from polarization to reconciliation. The journal of ECT 2000; 16: 87.
5. Squire LR. Human memory and amnesia. Neurobiology of learning and memory 1984: 3-64.
6. Abbasinazari M, Adib-Eshgh L, Rostami A, Beyraghi N, Dabir S, Jafari R. Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial. Asian journal of psychiatry 2015; 15: 5-9.
7. Vakil E, Grunhaus L, Nagar I, Ben-Chaim E, Dolberg OT, Dannon PN, Schreiber S. The effect of electroconvulsive therapy (ECT) on implicit memory: skill learning and perceptual priming in patients with major depression. Neuropsychologia 2000; 38: 1405-1414.
8. Sobin C, Sackeim HA, Prudic J, Devanand D. Predictors of retrograde amnesia following ECT. The American journal of psychiatry 1995.
9. Zervas IM, Calev A, Jandorf L, Schwartz J. Age-dependent effects of electroconvulsive therapy on memory. Convulsive therapy 1993.
10. Lerer B, Stanley M, McIntyre I, Altman H. Electroconvulsive shock and brain muscarinic receptors: relationship to anterograde amnesia. Life sciences 1984; 35: 2659-2664.
11. Lerer B. Studies on the role of brain cholinergic systems in the therapeutic mechanisms and adverse effects of ECT and lithium. Biological psychiatry 1985; 20: 20-40.
12. Andrade C, Singh NM, Thyagarajan S, Nagaraja N, Sanjay Kumar Rao N, Suresh Chandra J. Possible glutamatergic and lipid signalling mechanisms in ECT-induced retrograde amnesia: experimental evidence for involvement of COX-2, and review of literature. J Psych Res 2008; 42: 837-850.
13. Okiyama K, Smith DH, Thomas MJ, McIntosh TK. Evaluation of a novel calcium channel blocker,(S)-emopamil, on regional cerebral edema and neurobehavioral function after experimental brain injury. Journal of neurosurgery 1992; 77: 607-615.
14. Nagaraja N, Andrade C, Sudha S, Madan Singh N, Chandra JS, Venkataraman B. Glucocorticoid mechanisms may contribute to ECT-induced retrograde amnesia. Psychopharmacology 2007; 190: 73-80.
15. Forstermann U, Heldt R, Knappen F, Hertting G. Potential anticonvulsive properties of endogenous prostaglandins formed in mouse brain. Brain research 1982; 240: 303-310.
16. Kanno T, Yaguchi T, Nagata T, Shimizu T, Tanaka A, Nishizaki T. Indomethacin enhances learning and memory potential by interacting with CaMKII. Journal of cellular physiology 2012; 227: 919-926.
17. Chamberlin E, Tsai GE. A glutamatergic model of ECT-induced memory dysfunction. Harvard review of psychiatry 1998; 5: 307-317.
18. Kotilinek LA, Westerman MA, Wang Q, Panizzon K, Lim GP, Simonyi A, Lesne S, Falinska A, Younkin LH, Younkin SG. Cyclooxygenase-2 inhibition improves amyloid-β-mediated suppression of memory and synaptic plasticity. Brain 2008; 131: 651-664.
19. Hamilton M. A rating scale for depression. Journal of neurology, neurosurgery, and psychiatry 1960; 23: 56-62.
20. Ghasemi M, Kazemi MH, Yoosefi A, Ghasemi A, Paragomi P, Amini H, Afzali MH. Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder. Psychiatry research 2014; 215: 355-361.
21. Haghighi M, Salehi I, Erfani P, Jahangard L, Bajoghli H, Holsboer-Trachsler E, Brand S. Additional ECT increases BDNF-levels in patients suffering from major depressive disorders compared to patients treated with citalopram only. J Psychiatr Res 2013; 47: 908-915.
22. Mowla A, Mosavinasab M, Pani A. Does fluoxetine have any effect on the cognition of patients with mild cognitive impairment? A double-blind, placebo-controlled, clinical trial. Journal of clinical psychopharmacology 2007; 27: 67-70.
23. Martin DM, Katalinic N, Ingram A, Schweitzer I, Smith DJ, Hadzi-Pavlovic D, Loo CK. A new early cognitive screening measure to detect cognitive side-effects of electroconvulsive therapy? J Psychiatr Res 2013; 47: 1967-1974.
24. Rajkumar AP, Petit CP, Rachana A, Deinde F, Shyamsundar G, Thangadurai P, Jacob KS. Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India. Asian journal of psychiatry 2018; 34: 47-53.
25. Tulsky DS, Saklofske DH, Chelune GJ, Heaton RK, Ivnik RJ, Bornstein R, Prifitera A, Ledbetter MF: Clinical Interpretation of the WAIS-III and WMS-III (Practical Resources for the Mental Health Professional) 1st ed. Tulsky DS, Saklofske DH, Chelune GJ, Heaton RK, Ivnik RJ, Bornstein R, Prifitera A, Ledbetter MF, editors. San Diego, California, USA, Academic Press; 2003.
26. Tulsky DS. A new look at the WMS-III: new research to guide clinical practice. Journal of clinical and experimental neuropsychology 2004; 26: 453-458.
27. D'Elia L, Satz P, Schretlen D. Wechsler Memory Scale: a critical appraisal of the normative studies. Journal of clinical and experimental neuropsychology 1989; 11: 551-568.
28. Stroop JR. Studies of interference in serial verbal reactions. Journal of Experimental Psychology 1935; 18: 643-662.
29. Scarpina F, Tagini S. The Stroop Color and Word Test. Frontiers in psychology 2017; 8: 557.
30. Pagnin D, de Queiroz V, Pini S, Cassano GB. Efficacy of ECT in depression: a meta-analytic review. The journal of ECT 2004; 20: 13.
31. Andrade C, Thyagarajan S, Singh NM, Vinod PS, Sanjay Kumar Rao N, Chandra JS. Celecoxib as an in vivo probe of cyclooxygenase-2 mechanisms underlying retrograde amnesia in an animal model of ECT. Journal of neural transmission (Vienna, Austria : 1996) 2008; 115: 1063-1070.
32. Pigot M, Andrade C, Loo C. Pharmacological attenuation of electroconvulsive therapy--induced cognitive deficits: theoretical background and clinical findings. J ECT 2008; 24: 57-67.
33. Tassoni D, Kaur G, Weisinger RS, Sinclair AJ. The role of eicosanoids in the brain. Asia Pacific journal of clinical nutrition 2008; 17 Suppl 1: 220-228.
34. Rao SK, Andrade C, Reddy K, Madappa K, Thyagarajan S, Chandra S. Memory protective effect of indomethacin against electroconvulsive shock-induced retrograde amnesia in rats. Biological psychiatry 2002; 51: 770-773.
35. Rapoport SI. Arachidonic acid and the brain. The Journal of nutrition 2008; 138: 2515-2520.
36. Cuello AC, Ferretti MT, Leon WC, Iulita MF, Melis T, Ducatenzeiler A, Bruno MA, Canneva F. Early-stage inflammation and experimental therapy in transgenic models of the Alzheimer-like amyloid pathology. Neuro-degenerative diseases 2010; 7: 96-98.
37. Lipsky PE. The clinical potential of cyclooxygenase-2-specific inhibitors. The American journal of medicine 1999; 106: 51s-57s.
38. Dong J, Min S, Wei K, Li P, Cao J, Li Y. Effects of electroconvulsive therapy and propofol on spatial memory and glutamatergic system in hippocampus of depressed rats. J ect 2010; 26: 126-130.
39. Koola MM. Galantamine-Memantine Combination for Cognitive Impairments Due to Electroconvulsive Therapy, Traumatic Brain Injury, and Neurologic and Psychiatric Disorders: Kynurenic Acid and Mismatch Negativity Target Engagement. The primary care companion for CNS disorders 2018; 20.
40. Wang H, Peng RY. Basic roles of key molecules connected with NMDAR signaling pathway on regulating learning and memory and synaptic plasticity. Military Medical Research 2016; 3: 26.
41. Muller N, Riedel M, Schwarz M. Psychotropic effects of COX-2 inhibitors-a possible new approach for the treatment of psychiatric disorders. Pharmacopsychiatry 2004; 37: 266-269.
2. Weiner RD, Reti IM. Key updates in the clinical application of electroconvulsive therapy. International review of psychiatry (Abingdon, England) 2017; 29: 54-62.
3. Kumar S, Mulsant BH, Liu AY, Blumberger DM, Daskalakis ZJ, Rajji TK. Systematic Review of Cognitive Effects of Electroconvulsive Therapy in Late-Life Depression. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2016; 24: 547-565.
4. Sackeim HA. Memory and ECT: from polarization to reconciliation. The journal of ECT 2000; 16: 87.
5. Squire LR. Human memory and amnesia. Neurobiology of learning and memory 1984: 3-64.
6. Abbasinazari M, Adib-Eshgh L, Rostami A, Beyraghi N, Dabir S, Jafari R. Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial. Asian journal of psychiatry 2015; 15: 5-9.
7. Vakil E, Grunhaus L, Nagar I, Ben-Chaim E, Dolberg OT, Dannon PN, Schreiber S. The effect of electroconvulsive therapy (ECT) on implicit memory: skill learning and perceptual priming in patients with major depression. Neuropsychologia 2000; 38: 1405-1414.
8. Sobin C, Sackeim HA, Prudic J, Devanand D. Predictors of retrograde amnesia following ECT. The American journal of psychiatry 1995.
9. Zervas IM, Calev A, Jandorf L, Schwartz J. Age-dependent effects of electroconvulsive therapy on memory. Convulsive therapy 1993.
10. Lerer B, Stanley M, McIntyre I, Altman H. Electroconvulsive shock and brain muscarinic receptors: relationship to anterograde amnesia. Life sciences 1984; 35: 2659-2664.
11. Lerer B. Studies on the role of brain cholinergic systems in the therapeutic mechanisms and adverse effects of ECT and lithium. Biological psychiatry 1985; 20: 20-40.
12. Andrade C, Singh NM, Thyagarajan S, Nagaraja N, Sanjay Kumar Rao N, Suresh Chandra J. Possible glutamatergic and lipid signalling mechanisms in ECT-induced retrograde amnesia: experimental evidence for involvement of COX-2, and review of literature. J Psych Res 2008; 42: 837-850.
13. Okiyama K, Smith DH, Thomas MJ, McIntosh TK. Evaluation of a novel calcium channel blocker,(S)-emopamil, on regional cerebral edema and neurobehavioral function after experimental brain injury. Journal of neurosurgery 1992; 77: 607-615.
14. Nagaraja N, Andrade C, Sudha S, Madan Singh N, Chandra JS, Venkataraman B. Glucocorticoid mechanisms may contribute to ECT-induced retrograde amnesia. Psychopharmacology 2007; 190: 73-80.
15. Forstermann U, Heldt R, Knappen F, Hertting G. Potential anticonvulsive properties of endogenous prostaglandins formed in mouse brain. Brain research 1982; 240: 303-310.
16. Kanno T, Yaguchi T, Nagata T, Shimizu T, Tanaka A, Nishizaki T. Indomethacin enhances learning and memory potential by interacting with CaMKII. Journal of cellular physiology 2012; 227: 919-926.
17. Chamberlin E, Tsai GE. A glutamatergic model of ECT-induced memory dysfunction. Harvard review of psychiatry 1998; 5: 307-317.
18. Kotilinek LA, Westerman MA, Wang Q, Panizzon K, Lim GP, Simonyi A, Lesne S, Falinska A, Younkin LH, Younkin SG. Cyclooxygenase-2 inhibition improves amyloid-β-mediated suppression of memory and synaptic plasticity. Brain 2008; 131: 651-664.
19. Hamilton M. A rating scale for depression. Journal of neurology, neurosurgery, and psychiatry 1960; 23: 56-62.
20. Ghasemi M, Kazemi MH, Yoosefi A, Ghasemi A, Paragomi P, Amini H, Afzali MH. Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder. Psychiatry research 2014; 215: 355-361.
21. Haghighi M, Salehi I, Erfani P, Jahangard L, Bajoghli H, Holsboer-Trachsler E, Brand S. Additional ECT increases BDNF-levels in patients suffering from major depressive disorders compared to patients treated with citalopram only. J Psychiatr Res 2013; 47: 908-915.
22. Mowla A, Mosavinasab M, Pani A. Does fluoxetine have any effect on the cognition of patients with mild cognitive impairment? A double-blind, placebo-controlled, clinical trial. Journal of clinical psychopharmacology 2007; 27: 67-70.
23. Martin DM, Katalinic N, Ingram A, Schweitzer I, Smith DJ, Hadzi-Pavlovic D, Loo CK. A new early cognitive screening measure to detect cognitive side-effects of electroconvulsive therapy? J Psychiatr Res 2013; 47: 1967-1974.
24. Rajkumar AP, Petit CP, Rachana A, Deinde F, Shyamsundar G, Thangadurai P, Jacob KS. Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India. Asian journal of psychiatry 2018; 34: 47-53.
25. Tulsky DS, Saklofske DH, Chelune GJ, Heaton RK, Ivnik RJ, Bornstein R, Prifitera A, Ledbetter MF: Clinical Interpretation of the WAIS-III and WMS-III (Practical Resources for the Mental Health Professional) 1st ed. Tulsky DS, Saklofske DH, Chelune GJ, Heaton RK, Ivnik RJ, Bornstein R, Prifitera A, Ledbetter MF, editors. San Diego, California, USA, Academic Press; 2003.
26. Tulsky DS. A new look at the WMS-III: new research to guide clinical practice. Journal of clinical and experimental neuropsychology 2004; 26: 453-458.
27. D'Elia L, Satz P, Schretlen D. Wechsler Memory Scale: a critical appraisal of the normative studies. Journal of clinical and experimental neuropsychology 1989; 11: 551-568.
28. Stroop JR. Studies of interference in serial verbal reactions. Journal of Experimental Psychology 1935; 18: 643-662.
29. Scarpina F, Tagini S. The Stroop Color and Word Test. Frontiers in psychology 2017; 8: 557.
30. Pagnin D, de Queiroz V, Pini S, Cassano GB. Efficacy of ECT in depression: a meta-analytic review. The journal of ECT 2004; 20: 13.
31. Andrade C, Thyagarajan S, Singh NM, Vinod PS, Sanjay Kumar Rao N, Chandra JS. Celecoxib as an in vivo probe of cyclooxygenase-2 mechanisms underlying retrograde amnesia in an animal model of ECT. Journal of neural transmission (Vienna, Austria : 1996) 2008; 115: 1063-1070.
32. Pigot M, Andrade C, Loo C. Pharmacological attenuation of electroconvulsive therapy--induced cognitive deficits: theoretical background and clinical findings. J ECT 2008; 24: 57-67.
33. Tassoni D, Kaur G, Weisinger RS, Sinclair AJ. The role of eicosanoids in the brain. Asia Pacific journal of clinical nutrition 2008; 17 Suppl 1: 220-228.
34. Rao SK, Andrade C, Reddy K, Madappa K, Thyagarajan S, Chandra S. Memory protective effect of indomethacin against electroconvulsive shock-induced retrograde amnesia in rats. Biological psychiatry 2002; 51: 770-773.
35. Rapoport SI. Arachidonic acid and the brain. The Journal of nutrition 2008; 138: 2515-2520.
36. Cuello AC, Ferretti MT, Leon WC, Iulita MF, Melis T, Ducatenzeiler A, Bruno MA, Canneva F. Early-stage inflammation and experimental therapy in transgenic models of the Alzheimer-like amyloid pathology. Neuro-degenerative diseases 2010; 7: 96-98.
37. Lipsky PE. The clinical potential of cyclooxygenase-2-specific inhibitors. The American journal of medicine 1999; 106: 51s-57s.
38. Dong J, Min S, Wei K, Li P, Cao J, Li Y. Effects of electroconvulsive therapy and propofol on spatial memory and glutamatergic system in hippocampus of depressed rats. J ect 2010; 26: 126-130.
39. Koola MM. Galantamine-Memantine Combination for Cognitive Impairments Due to Electroconvulsive Therapy, Traumatic Brain Injury, and Neurologic and Psychiatric Disorders: Kynurenic Acid and Mismatch Negativity Target Engagement. The primary care companion for CNS disorders 2018; 20.
40. Wang H, Peng RY. Basic roles of key molecules connected with NMDAR signaling pathway on regulating learning and memory and synaptic plasticity. Military Medical Research 2016; 3: 26.
41. Muller N, Riedel M, Schwarz M. Psychotropic effects of COX-2 inhibitors-a possible new approach for the treatment of psychiatric disorders. Pharmacopsychiatry 2004; 37: 266-269.
| Files | ||
| Issue | Vol 57, No 11 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v57i11.3257 | |
| Keywords | ||
| Celecoxib Cognition Cyclooxygenase-2 Electroconvulsive therapy (ECT) Major depressive disorder Memory impairment | ||
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How to Cite
1.
Banaha N, Ghaeli P, Yousefi A, Artounian V, Afzali MH, Ghasemi M. Effects of Celecoxib on Electroconvulsive Therapy-Induced Cognitive Impairment in Patients With Major Depressive Disorder: A Pilot, Double-Blind, Placebo-Controlled Trial. Acta Med Iran. 2020;57(11):627-634.
