Vortioxetine use in demented patients

Abstract

Background Vortioxetine is a new antidepressant with a distinctive pharmacological profile. It combines inhibition of serotinine transporter with modulation of various serotonine receptors. Its cognitive benefit in adults depressed patients has been previously demonstrated. There is evidence of its antidepressant effect in the elderly but not specifically of its utiliity in demented population. Effects in a group of different types of dementia patients are showed and hypothesis of its efficacy based on its properties are proposed. Method A retrospective study was conducted. Eligible patients were those observed in our memory outpatient clinics during 2019. All patients had behavioural symptoms (BPSD), Main symptoms were anxiety, apathy, irritability and restlessness. Thirty‐two patients were reviewed. Result 32 patients were included, of which 60,6% were women. Median age was 74 years (SD 12,070). Alzheimer´s disease was the most common type of dementia (51.5%), as expected. Median dose of vortioxetine used was 10 mg/day. Symptoms that led to vortioxetine initiation were anxiety (57,6%), apathy (48,5%) and irritability (42,4%). Depreesion was present in 33,3% of cases, but anxiety and apathy were the symptoms that improved the most after vortioxetine introduction. 60,6% of patients were concomitantly treated with antidementia drugs, mostly Rivastigmine (30,3%). Coexistent benzodiazepines or antipsychotics use in patients treated with vortioxetine was not significant (24,2% and 21,2% each one). No side effects were reported. Conclusion Vortioxetine may be an useful option for BPSD in dementia population. Available evidence indicates that target receptors for vortioxetine play an important role in brain networks, and this could explain its efficacy regardless the antidepressive effect. No safety concerns were found in this group of patients with doses from 10 to 20 mg/day according with tolerability profile already described. Further studies with a more extensive number of eligible patients and prospective design are needed.

Effectiveness of vortioxetine in patients with major depressive disorder and comorbid Alzheimer’s disease in routine clinical practice: An analysis of a post-marketing surveillance study in South Korea

“…Vortioxetine treatment was associated with significant improvements in cognitive function in an open-label study in community-dwelling older adults with mild cognitive impairment ( Tan and Tan, 2021 ). A small retrospective cohort study has also demonstrated improvements in behavioral and psychological symptoms of dementia during treatment with vortioxetine ( Valverde et al, 2020 ).…”