Vortioxetine Induced Hypomania: A Case Presentation and Review of the Literature

Tunc, Ece Buyuksandalyaci; Tunç, Serhat

doi:10.9758/cpn.2022.20.2.394

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Clinicians should follow this warning and monitor their patients carefully. In addition, we acknowledge the emerging literature pointing towards vortioxetine's potential risks of inducing hypomania, as reported in several case studies 32–37 . The efficacy of vortioxetine for treating pediatric patients with depression has not been confirmed.…”

Section: Discussionmentioning

confidence: 93%

“…In addition, we acknowledge the emerging literature pointing towards vortioxetine's potential risks of inducing hypomania, as reported in several case studies. 32 , 33 , 34 , 35 , 36 , 37 The efficacy of vortioxetine for treating pediatric patients with depression has not been confirmed. Therefore, its use is not approved in the United States or the European Union and is only permitted in Japan after careful consideration.…”

Section: Discussionmentioning

confidence: 99%

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Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases

Arai,

Nonaka,

Shimada

et al. 2023

PCN Reports

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BackgroundJitteriness/anxiety syndrome is a recognized adverse effect observed during the initiation or change of dose in antidepressant treatment. Managing patients who develop this syndrome remains a challenge. While escitalopram is a widely used antidepressant known to cause these symptoms, this report explores vortioxetine as a therapeutic alternative.Case PresentationThree distinct clinical scenarios were observed in patients who manifested jitteriness/anxiety syndrome while on escitalopram treatment for depression. Patient A was initiated on escitalopram and experienced an initial alleviation in depressive symptoms, but 3 months later displayed mood elevation, talkativeness, and increased activity, which disturbed his daily life. A transition to vortioxetine subsequently resolved the mood elevation. Patient B exhibited elevated mood, hyperactivity, irritability, and talkativeness just 6 days post‐initiation of treatment with escitalopram. After the discontinuation of escitalopram and unsuccessful trials with aripiprazole, lurasidone, and lamotrigine, her depressive mood intensified, culminating in suicidal ideation. Starting vortioxetine led to a consistent improvement of her symptoms, and she resumed work and was emotionally stable. Patient C was initially diagnosed with bipolar disorder and faced a relapse into depression despite undergoing various treatments. After 2 weeks on escitalopram, she exhibited irritability and self‐harm urges. Three months later, after being re‐diagnosed with depressive disorders with anxious distress, vortioxetine was administered, which significantly reduced her depressive symptoms and allowed her to continue her education.ConclusionVortioxetine presents as a promising therapeutic alternative that is worth considering for patients with escitalopram‐induced jitteriness/anxiety syndrome.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases

Arai,

Nonaka,

Shimada

et al. 2023

PCN Reports

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show abstract

“…Like traditional selective serotonin reuptake inhibitors, it can increase serotonin levels through inhibition of serotonin transporters (SERTs). However, its action on various subtypes of 5HT receptors gives vortioxetine its unique characteristics; Its effect on dopamine, Gaba-aminobuturic acid, Noradrenaline and Acetylcholine has made it accepted as a multimodal antidepressant [ 17 - 20 ]. In animal studies, it has been shown to increase dopamine and noradrenaline, especially in the prefrontal cortex and ventral hippo-campus.…”

Section: Discussionmentioning

confidence: 99%

Potential Effect of Vortioxetine on Restless Leg Syndrome

Alıcı

Kumcu

2023

Clin Psychopharmacol Neurosci

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Restless legs syndrome (RLS) is a chronic progressive movement disorder characterized by abnormal sensations, especially at rest and at night, as the need and urge to move the lower extremity. It has been reported that RLS severity and frequency increase in patients with anxiety and depression. It has been reported that serotonin-noradrenaline reuptake inhibitors such as venlafaxine and selective serotonin reuptake inhibitors such as citalopram, fluoxetine, paroxetine, and sertraline can cause RLS symptoms. No adverse effects of vortioxetine on RLS have been reported in the literature. In this case series, we report the effect of vortioxetine in patients with RLS with symptoms of depression and anxiety. In this case series, the effect of adding vortioxetine to treatment on RLS symptoms is reported in 7 patients (5 female). After the use of vortioxetine, 5 of 7 patients’ symptoms regressed without the need to start a separate drug for primary movement disorder. In conclusion, we believe that studies should be conducted to investigate the efficacy of vortioxetine in the treatment of RLS. Therefore, randomized controlled studies are needed to determine the effect and safety of vortioxetine on RLS symptoms.

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“…One report refers to two cases of Meige syndrome (bilateral orofacial dystonia with perioral dyskinesia and blepharospasm), which occurred in two sisters, both ten days after vortioxetine introduction and resolved a few days after vortioxetine discontinuation [143]. Vortioxetine was also associated with two cases of manic switch that occurred after vortioxetine introduction (10 mg/day) in two female patients previously diagnosed with unipolar depression [144,145]. One of the two patients had a history of multiple antidepressant treatments (escitalopram, fluoxetine, paroxetine, and duloxetine) without evidence of former manic reactions.…”

Section: Descriptive Observational Studiesmentioning

confidence: 99%

The Role of Vortioxetine in the Treatment of Depressive Symptoms in General Hospital Psychiatry: A Case-Series and PRISMA-Compliant Systematic Review of the Literature

Weiss,

Pacciardi,

D’Alessandro

et al. 2024

JCM

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Depressive symptoms are a customary finding in hospitalized patients, particularly those who are undergoing long hospitalizations, underwent major surgical procedures or suffer from high levels of multimorbidity and frailty. The patients included in this case series shared high degrees of frailty-complexity and were evaluated within the ordinary consultation and liaison psychiatry service of the University Hospital in Pisa, Italy, from September 2021 to June 2023. Patients were administered at least one follow-up evaluation after a week and before discharge. To relate this case series to the extant literature, a comprehensive systematic review of vortioxetine safety and efficacy was performed. None of the six patients included developed serious safety issues, but one patient complained of mild-to-moderate nausea for some days after the vortioxetine introduction. Five out of six patients exhibited at least a slight clinical benefit as measured by the clinical global impression scale. Of the 858 entries screened via Scopus and Medline/PubMed, a total of 134 papers were included in our review. The present case series provides preliminary evidence for vortioxetine’s safety in this healthcare domain. The literature reviewed in this paper seems to endorse a promising safety profile and a very peculiar efficacy niche for vortioxetine in consultation and liaison psychiatry.

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Vortioxetine Induced Hypomania: A Case Presentation and Review of the Literature

Cited by 6 publications

References 27 publications

Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases

Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases

Potential Effect of Vortioxetine on Restless Leg Syndrome

The Role of Vortioxetine in the Treatment of Depressive Symptoms in General Hospital Psychiatry: A Case-Series and PRISMA-Compliant Systematic Review of the Literature

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