Indian Journal of Private Psychiatry

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VOLUME 14 , ISSUE 2 ( July-December, 2020 ) > List of Articles


A “Real-World” Chart Review Study of Monotherapy and Adjunctive Vortioxetine in Clinical Practice

Ruksheda Syeda

Keywords : Cognition, Depression, Side effects, Vortioxetine

Citation Information : Syeda R. A “Real-World” Chart Review Study of Monotherapy and Adjunctive Vortioxetine in Clinical Practice. Ind J Priv Psychiatry 2020; 14 (2):92-94.

DOI: 10.5005/jp-journals-10067-0059

License: CC BY-NC 4.0

Published Online: 31-07-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Vortioxetine is a novel antidepressant drug that proved effective in the treatment of major depressive disorder (MDD) and anxiety disorder. It is a unique antidepressant having a multimodal serotonergic mechanism of action and also has important effects on other neurotransmitters implicated in the neurobiology of depression. Keeping in mind the sparse literature on vortioxetine from India, this real-world chart review was conducted to assess its utility and effectiveness. Materials and methods: This is a multicentric retrospective chart analysis of all patients who were prescribed vortioxetine in outpatient psychiatric clinics set in urban areas. Patients prescribed the drug between January 1, 2019, and December 31, 2019, were included in the study. The chart review included details regarding the reason for starting vortioxetine, dosage, side effects observed, duration, and adjunctive medications that the patient had. Descriptive statistics were used in the analysis and the data were presented. Results: The chart review had data of 131 patients. Of these, 85 patients are still maintained on vortioxetine. Majority of the subjects suffered from a MDD. Other indications for the use of vortioxetine included anxiety disorders, obsessive-compulsive disorders, and borderline personality disorder. Only 12 patients suffered side effects which were minor. Majority of the patients reported good improvement with the drug and cost of the drug was a major deterrent to continuing long-term treatment with the drug. Conclusions: Vortioxetine was found to be efficacious with minimal side effects. It may improve cognition in depression and has a lower incidence of treatment-emergent sexual dysfunction. Further data from diverse patient populations are needed before we comment on its effectiveness and safety.

  1. Lépine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat 2011;7(Suppl 1):3–7. DOI: 10.2147/NDT.S19617.
  2. Greenberg PE, Fournier AA, Sisitsky T, et al. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry 2015;76(2):155–162. DOI: 10.4088/JCP.14m09298.
  3. Sanchez C, Asin KE, Artigas F. Vortioxetine, a novel antidepressant with multimodal activity: review of preclinical and clinical data. Pharmacol Therapeut 2015;145:43–57. DOI: 10.1016/j.pharmthera.2014.07.001.
  4. Deardorff WJ, Grossberg GT. A review of the clinical efficacy, safety and tolerability of the antidepressants vilazodone, levomilnacipran and vortioxetine. Exp Opin Pharmacother 2014;15(17):2525–2542. DOI: 10.1517/14656566.2014.960842.
  5. Stahl SM. Modes and nodes explain the mechanism of action of vortioxetine, a multimodal agent (MMA): enhancing serotonin release by combining serotonin (5HT) transporter inhibition with actions at 5HT receptors (5HT1A, 5HT1B, 5HT1D, 5HT7 receptors). CNS Spectr 2015;20(2):93–97. DOI: 10.1017/S1092852915000139.
  6. Katona CL, Katona CP. New generation multi-modal antidepressants: focus on vortioxetine for major depressive disorder. Neuropsychiatr Dis Treat 2014;10:349–354. DOI: 10.2147/NDT.S39544.
  7. Gibb A, Deeks ED. Vortioxetine: first global approval. Drugs 2014;74(1):135–145. DOI: 10.1007/s40265-013-0161-9.
  8. Pae CU, Wang SM, Han C, et al. Vortioxetine, a multimodal antidepressant for generalized anxiety disorder: a systematic review and meta-analysis. J Psychiatr Res 2015;64:88–98. DOI: 10.1016/j.jpsychires.2015.02.017.
  9. De Berardis D, Olivieri L, Nappi F, et al. Vortioxetine and aripiprazole combination in treatment-resistant obsessive-compulsive disorder: a case report. J Clin Psychopharmacol 2017;37(6):732–734. DOI: 10.1097/JCP.0000000000000801.
  10. American Psychiatric Association. Diagnostic and statistical manual for the classification of psychiatric disorders. 5th ed. New York: American Psychiatric Publishing; 2013.
  11. Pehrson AL, Leiser SC, Gulinello M, et al. Treatment of cognitive dysfunction in major depressive disorder—a review of the preclinical evidence for efficacy of selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors and the multimodal-acting antidepressant vortioxetine. Eur J Pharmacol 2015;753:19–31. DOI: 10.1016/j.ejphar.2014.07.044.
  12. McIntyre RS, Lophaven S, Olsen CK. A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults. Int J Neuropsychopharmacol 2014;17(10):1557–1567. DOI: 10.1017/S1461145714000546.
  13. Chen G, Højer AM, Areberg J, et al. Vortioxetine: clinical pharmacokinetics and drug interactions. Clin Pharmacokinet 2018;57(6):673–686. DOI: 10.1007/s40262-017-0612-7.
  14. Riga MS, Sánchez C, Celada P, Artigas F. Involvement of 5-HT3 receptors in the action of vortioxetine in rat brain: focus on glutamatergic and GABAergic neurotransmission. Neuropharmacology 2016;108:73–81. DOI: 10.1016/j.neuropharm.2016.04.023.
  15. McIntyre RS, Harrison J, Loft H, et al. The effects of vortioxetine on cognitive function in patients with major depressive disorder: a meta-analysis of three randomized controlled trials. Int J Neuropsychopharmacol 2016;19(10):pyw055. DOI: 10.1093/ijnp/pyw055.
  16. Connolly KR, Thase ME. Vortioxetine: a new treatment for major depressive disorder. Exp Opin Pharmacother 2016;17(3):421–431. DOI: 10.1517/14656566.2016.1133588.
  17. Schatzberg AF, Blier P, Culpepper L, et al. An overview of vortioxetine. J Clin Psychiatry 2014;75(12):1411–1418. DOI: 10.4088/JCP.14027ah1.
  18. Sobreira G, Oliveira J, Brissos S. Vortioxetine-induced manic mood switch in patient with previously unknown bipolar disorder. Braz J Psychiatry 2017;39(1):86–88. DOI: 10.1590/1516-4446-2016-2113.
  19. Pirdoğan Aydın E, Dalkıran M, Özer ÖA, et al. Hypomanic switch during vortioxetine treatment: a case report. Psychiatr Clin Psychopharmacol 2019;29(1):114–116. DOI: 10.1080/24750573.2018.1435602.
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