EXPERT OPINION Results of placebo-controlled trials suggest efficacy and an overall safety profile comparable to existing first-line antidepressants .
The most common side effects are nausea , vomiting and constipation .
Results of several studies indicate that vortioxetine may have therapeutic effects on cognition ( e.g. , memory and executive functioning ) that exceed that of st and ard antidepressants .
The authors suggest that vortioxetine is currently a good second-line antidepressant option and shows promise , pending additional long-term data , to become a first-line antidepressant option
INTRODUCTION Vortioxetine is a structurally novel medication that has recently been approved for treatment of major depressive disorder ( MDD ) .
This medication is a serotonin reuptake inhibitor that also has a number of other potentially relevant effects on serotoninergic receptors , which may differentiate the drug 's effects from those of current first-line antidepressants , such as selective serotonin reuptake inhibitors ( SSRIs ) and serotonin norepinephrine reuptake inhibitors ( SNRIs ) .
AREAS COVERED This article will review the basic clinical pharmacology of vortioxetine , summarize the major clinical trials that were performed prior to approval by the US Food and Drug Administration ( FDA ) , discuss relevant post-marketing studies of this drug , and offer expert commentary on the significance of this new agent in clinical practice .
Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder
Anxiety symptoms are prevalent in patients with major depressive disorder . A post-hoc analysis of two phase III trials was conducted to evaluate the efficacy of vilazodone on depression-related anxiety . Using the 17-item Hamilton Depression Rating Scale ( HAMD17 ) Anxiety/Somatization subscale , patients were classified as anxious or nonanxious . Improvements in depressive symptoms were based on least squares mean changes in HAMD17 and Montgomery – Asberg Depression Rating Scale total scores . Anxiety symptoms in the anxious subgroup were evaluated using Hamilton Anxiety Rating Scale ( HAMA ) total and subscale ( Psychic Anxiety , Somatic Anxiety ) scores , HAMD17 Anxiety/Somatization subscale and item ( Psychic Anxiety , Somatic Anxiety ) scores , and the Montgomery – Asberg Depression Rating Scale Inner Tension item score . Most of the pooled study population [ 82.0 % ( 708/863 ) ] was classified with anxious depression . After 8 weeks of treatment , least squares mean differences between vilazodone and placebo for changes in HAMA total and HAMD17 Anxiety/Somatization subscale scores were −1.82 ( 95 % confidence interval −2.81 to −0.83 ; P<0.001 ) and −0.75 ( 95 % confidence interval −1.17 to −0.32 ; P<0.001 ) , respectively . Statistically significant improvements with vilazodone were also found on all other anxiety-related measures , except the HAMA Somatic Anxiety subscale .  Vilazodone may be effective in treating patients with major depressive disorder who exhibit somatic and /or psychic symptoms of anxiety
EXPERT OPINION Results of placebo-controlled trials suggest efficacy and an overall safety profile comparable to existing first-line antidepressants .
The most common side effects are nausea , vomiting and constipation .
Results of several studies indicate that vortioxetine may have therapeutic effects on cognition ( e.g. , memory and executive functioning ) that exceed that of st and ard antidepressants .
The authors suggest that vortioxetine is currently a good second-line antidepressant option and shows promise , pending additional long-term data , to become a first-line antidepressant option
INTRODUCTION Vortioxetine is a structurally novel medication that has recently been approved for treatment of major depressive disorder ( MDD ) .
This medication is a serotonin reuptake inhibitor that also has a number of other potentially relevant effects on serotoninergic receptors , which may differentiate the drug 's effects from those of current first-line antidepressants , such as selective serotonin reuptake inhibitors ( SSRIs ) and serotonin norepinephrine reuptake inhibitors ( SNRIs ) .
AREAS COVERED This article will review the basic clinical pharmacology of vortioxetine , summarize the major clinical trials that were performed prior to approval by the US Food and Drug Administration ( FDA ) , discuss relevant post-marketing studies of this drug , and offer expert commentary on the significance of this new agent in clinical practice .