Abstract
Vortioxetine is an antidepressant with multimodal mechanism of action, acting as 5-HT3A and 5-HT7 receptor antagonist, 5-HT1A agonist, 5-HT1B partial agonist, and serotonin transporter inhibitor. The paper reviews updated data on vortioxetine.
In the total of seven double-blind controlled trials vortioxetine 10-20 mg daily was significantly more effective than placebo, in one study was superior to duloxetine and one trial showed noninferiority of vortioxetine to venlafaxine. Available evidence from long-term trials (one double-blind, placebo-controlled trial and two open extensions of acute studies) suggests that vortioxetine can be effective in relapse prevention, as well.
Vortioxetine was well-tolerated; most frequently reported side effects were transient and dose-dependent nausea and vomiting. In addition to improvement of depressive symptoms, vortioxetine showed positive effects on on cognition in depression.
Theoretical underpinning of procognitive action of vortioxetine (5-HT3 antagonism and 5-HT1A receptor agonism) has been confirmed in both animal studies, behavioral models, increased synaptogenesis and neuroplasticity, and in clinical trials with healthy volunteers and depressed patients. In elderly patients vortioxetine was significantly more effective than placebo in improvement of cognitive performance and in adult patients improved cognitive functions better than duloxetine, independent of antidepressive effects.