Vortioxetine: A review of the pharmacology and clinical profile of the novel antidepressant

Sowa-Kućma, Magdalena; Pańczyszyn-Trzewik, Patrycja; Misztak, Paulina; Jaeschke, Rafał; Sendek, Katherine; Styczeń, Krzysztof; Datka, Wojciech; Koperny, Magdalena

doi:10.1016/j.pharep.2017.01.030

Cited by 55 publications

(46 citation statements)

References 50 publications

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“…Theoretically, the concomitant use of vortioxetine and an SSRI may boost serotonergic activity without further postsynaptic 5-HT 2A blockade (thus limiting the SSRI dose-related side effects). 16,26 Moreover, the partial agonist effect of vortioxetine on the postsynaptic 5HT 1B heteroreceptors located in GABAergic interneurons may increase the release of glutamate in the hippocampus and prefrontal cortex, which may further contribute to an antidepressant effect. 27 This mechanism of action may also increase clinical efficacy in treating cognitive symptoms, which are frequently present in patients with suboptimal or inadequate response to antidepressants, and thus contribute to the achievement of complete remission in everyday clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study

Berardis¹,

Fornaro

Anastasia

et al. 2020

Braz. J. Psychiatry

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Objective: Selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of treatment of major depressive disorder (MDD). However, non-response is common, often necessitating combination strategies. The present study assessed the efficacy of vortioxetine as an add-on therapy in patients with SSRI-resistant MDD. Methods: The charts of 36 adult outpatients with DSM-IV-TR MDD who had not achieved a response after at least 8 weeks of treatment with an SSRI were reviewed retrospectively. Subjects were treated with vortioxetine (5-20 mg/day) for 8 weeks added to the current SSRI. The main outcome measures were change from baseline in total Hamilton Scale for Depression (HAM-D) score and the rate of response (a 50% or greater reduction in HAM-D score and a Clinical Global Impression-Improvement module [CGI-I] score of 1 or 2 at endpoint). HAM-D scores p 7 were considered as remission. Additional outcome measures included the Snaith-Hamilton Pleasure Scale (SHAPS) and the Scale for Suicide Ideation (SSI). Results: 32 patients completed the 8 weeks of treatment. At 8 weeks, a significant reduction in HAM-D score was observed (p p 0.001), with response obtained by 41.7% and remission by 33.3% of patients. Significant reductions in SHAPS and SSI were also observed (p p 0.001 for both scales). Conclusions: Adjunctive vortioxetine may be useful and well-tolerated in stage I treatment-resistant depression. However, the limitations of this study (such as small sample size, absence of randomization and control group, retrospective design, etc.) must be considered.

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Section: Discussionmentioning

confidence: 99%

Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study

Berardis¹,

Fornaro

Anastasia

et al. 2020

Braz. J. Psychiatry

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“…In animal models, it was found that inhibition of SERT as well as the 5-HT 1B receptor increases the serotonin concentration in the prefrontal cortex, while agonists of this receptor increase the rate of firing of serotonergic neurons in the raphe nucleus [33]. This research direction allows new drugs to be introduced into the clinic, e.g., vortioxetine [34]. In presented study on the affinity of Cr(III) to selected receptors and transporters, no affinity to SERT, α 1 , and β 1 was found; very poor activity was determined in relation to the 5-HT 1A receptor.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Density Changes of Selected Brain Receptors After a 14-Day Supply of Chromium(III) and Evaluation of Chromium(III) Affinity to Selected Receptors and Transporters

Piotrowska

Siwek

Wolak

et al. 2019

Biol Trace Elem Res

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Chromium(III) is one of the most controversial biometals. Although, it is no longer on the list of minerals necessary for the proper functioning of the human body, and its pharmacological effect is still under discussion. One of the purposes of Cr(III) administration is to use it in patients with mood disorders and it is strictly related to its pharmacological, not dietary effect. This is because its high doses are necessary to obtain the results and additionally, no deficiencies in human population have been noted. In this study, the affinity of chromium(III) to selected receptors and transporters in the rat brain was evaluated, and the effect of the 14-day administration of this metal was assessed on the density of selected receptors. All analyses were performed in vitro using radioligand binding assays, and the results indicated lack of affinity to β 1 and α 1 receptors and serotonin transporter (SERT), furthermore very weak affinity to the 5-HT 1A receptor (30% inhibition at 10 −4 and 10 −5 M). Analysis of the α 1 and β 1 adrenergic receptor density indicated lack of any adaptive effects after 14 days of Cr(III) administration through intraperitoneal injections (doses 6 and 12 mg/kg). The antidepressant activity of chromium(III) indicated in clinical trials concerned patients with atypical, seasonal, or dystonic symptoms. This effect, as it seems based on the presented results, does not depend on direct affinity to serotonin receptors and transporter nor is the result of adaptive changes in the adrenoreceptor system.

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“…One of the most recently registered AD widely modulates neurotransmission in the CNS directly through serotonin receptors, and indirectly through other pathways [77]. It is considered one of the fastest-acting AD with first effects that can be seen after two weeks of therapy [78]. Despite proven anxiolytic properties, it seems that the drug is more activating in nature, especially in the first period of use, which may translate into a lack of sleep-regulating or anxiolytic effect during this period, and consequently no improvement felt by the patient until the antidepressant effect of the drug is activated [79,80].…”

Section: Vortioxetinementioning

confidence: 99%

“…Najnowszy spośród zarejestrowanych w Polsce leków przeciwdepresyjnych wykazuje szeroko moduluje neuroprzekaźnictwo w OUN bezpośrednio poprzez receptory serotoninowe, a pośrednio poprzez pozostałe szlaki [77]. Jest uznawany za jeden z najszybciej działających AD z pierwszymi efektami, które mogą być widoczne już po 2 tygodniach terapii [78]. Mimo udowodnionego działania przeciwlękowego, wydaje się, że lek ma bardziej charakter aktywizujący, zwłaszcza w pierwszym okresie stosowania, co przekłada się na brak efektu regulującego sen lub anksjolitycznego w tym okresie, a w konsekwencji brak odczuwalnej przez pacjenta poprawy do momentu uaktywnienia się działania przeciwdepresyjnego leku [79,80].…”

Section: Farmakoterapia Depresji -Założenia Ogólneunclassified

Farmakoterapia depresji u pacjentów z zaawansowanymi chorobami

Grabowski¹,

Przybylak²

2019

Palliat Med Pract

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Sadness and anxiety are natural reactions to approaching death. However, sometimes these symptoms reach the significant intensity and are associated with the development of a depressive episode in people at the end of life. Diagnosis of depression may mean that somatic symptoms of advanced disease are subject to exacerbation due to the mental condition (reduced pain threshold, fatigue, sleep disorders, reduced appetite). Depressive patients will be less likely to cooperate in treatment, which may lead to deterioration of overall health, worse prognosis and higher mortality. It seems, therefore, that pharmacotherapy of depression in end-of-life patients should not be marginalized. However, due to antidepressants' delayed onset of action most patients probably fail to achieve satisfactory improvement on time. We propose as the first target for the treatment of depression in palliative care a fast and safe reduction of symptoms. Without giving up the basic antidepressant treatment, expected risk and benefits should be carefully and individually considered before the inclusion of standard medications, especially in terms of remaining life expectancy. We also believe that, if started, such pharmacotherapy should often be accompanied by medications that can quickly alleviate at least some depression symptoms making it easier for the patient to wait for the beneficial effect of the drug. Focusing on the rapid improvement of mental state, mianserin, mirtazapine, pregabalin, quetiapine, trazodone and vortioxetine seem to be beneficial for use in palliative care. Med Pract 2019; 13, 2: 82-89 Palliat

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Vortioxetine: A review of the pharmacology and clinical profile of the novel antidepressant

Cited by 55 publications

References 50 publications

Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study

Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study

Analysis of Density Changes of Selected Brain Receptors After a 14-Day Supply of Chromium(III) and Evaluation of Chromium(III) Affinity to Selected Receptors and Transporters

Farmakoterapia depresji u pacjentów z zaawansowanymi chorobami

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