Amitriptyline selectively disrupts verbal recall from secondary memory of the normal aged.

Amitriptyline, a frequently prescribed tricyclic antidepressant, is reported to produce an age-related impairment in anterograde memory. However, the locus of this adverse effect has never been described within the context of contemporary learning and memory theory. Fifteen normal elderly subjects were treated with 50 mg amitriptyline and placebo in a cross-over study. A computerized stage analysis of memory revealed that sensory and primary memory were not affected while verbal recall from secondary memory was markedly disrupted by amitriptyline. Further examination of secondary memory revealed that amitriptyline impaired recall, but not recognition. The profile of anterograde memory impairments observed with amitriptyline is similar to that previously reported for the antimuscarinic, scopolamine. Since amitriptyline at the dose employed in this study would be expected to exert marked central antimuscarinic effects, it appears likely that it is the pharmacologic blockade of central muscarinic receptors in the aged that results in the selective disruption of verbal recall in secondary memory.

Clinical pharmacology of bupropion and imipramine in elderly depressives.

The clinical efficacy and adverse reaction profile of bupropion, an atypical antidepressant, was compared with the tricyclic imipramine in 63 elderly depressives. Patients were randomly assigned to treatment with 150 or 450 mg/day of bupropion, 150 mg/day of imipramine, or placebo for 35 days. Both doses of bupropion were equivalent to imipramine in antidepressant efficacy. The higher dose of bupropion had a more rapid onset of effect than the low dose and significantly greater anxiolytic activity than either imipramine or the lower dose. Both doses of bupropion had adverse reaction profiles strikingly similar to placebo and, in marked contrast to imipramine, did not produce sedation or anticholinergic side effects. Cognition improved equally in all groups. It was concluded that bupropion has therapeutic advantages over the tricyclics in the treatment of elderly depressives.

Recall and recognition as diagnostic indices of Malignant Memory Loss in Senile Dementia: a Bayesian analysis.

The Benign Senescent Forgetfulness of normal aging and the Malignant Memory Loss of Senile Dementia of the Alzheimer Type (SDAT) each have a distinct symptomatology, course, and prognosis. The purpose of this study was to evaluate the discriminative validity and relative predictive values of recall and recognition as diagnostic screening tests for the Malignant Memory Loss of SDAT. Thirty-six patients with mild to moderate SDAT and 40 normal aged controls were studied. Both recall and recognition showed good discriminative validity. However, analysis of recall and recognition by Bayes's Theorem revealed the relative predictive values as diagnostic screening instruments were 11% and 100% respectively. Thus, it was concluded that while both recall and recognition have discriminative validity under experimental conditions, a test of recognition is the preferred diagnostic instrument when screening for the Malignant Memory Loss of SDAT.