Cognitive and Psychosocial Improvements Following Aripiprazole Augmentation of SSRI Antidepressant Therapy in Treatment Refractory Depression: A Pilot Study

Functional impairments are a common concern for individuals with major depressive disorder (MDD) that does not resolve with initial antidepressant treatment. Such concerns include cognitive difficulties, such as impaired executive functions, which can be particularly disruptive to daily function. There is a need to evaluate potential augmentation strategies for depressed individuals who do not adequately respond to initial antidepressant treatment. Aripiprazole is an FDA-approved adjunctive treatment to antidepressants for MDD, and because of its effect on both dopaminergic and serotonergic systems, may be of particular benefit to cognitive functioning. This study evaluated depressive symptom severity, cognitive function, and psychosocial function before and after six weeks of open-label aripiprazole augmentation treatment in patients with MDD who did not fully respond to selective serotonin reuptake inhibitor treatment. Participants endorsed difficulty with concentration and decision-making at study entry. Significant decreases were observed for depressive symptoms, and significant increases were found in executive function measures and measures of psychosocial function and quality of life. These preliminary data suggest that aripiprazole augmentation may yield functional benefits when used as an adjunctive treatment in MDD, and support the need for further investigation of aripiprazole and other augmentation strategies to specifically evaluate functional outcomes in MDD.