Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study

• Published in: Revista brasileira de psiquiatria Vol. 42; no. 3; pp. 317 - 321
• Main Authors: De Berardis, Domenico, Fornaro, Michele, Anastasia, Annalisa, Vellante, Federica, Olivieri, Luigi, Rapini, Gabriella, Serroni, Nicola, Orsolini, Laura, Valchera, Alessandro, Carano, Alessandro, Tomasetti, Carmine, Ventriglio, Antonio, Bustini, Massimiliano, Pompili, Maurizio, Serafini, Gianluca, Perna, Giampaolo, Iasevoli, Felice, Martinotti, Giovanni, Di Giannantonio, Massimo
• Format: Journal Article
• Language: English
• Published: Brazil Associação Brasileira de Psiquiatria 01.06.2020; Associação Brasileira de Psiquiatria (ABP)
• Subjects: Adult; Analysis of Variance; Antidepressive Agents - administration & dosage; augmentation; retrospective; Brief Communication; chart study; Depressive Disorder, Major - drug therapy; Depressive Disorder, Treatment-Resistant - drug therapy; Drug Therapy, Combination; Female; Humans; Male; Psychiatric Status Rating Scales; PSYCHIATRY; real world; Reproducibility of Results; Retrospective Studies; Serotonin and Noradrenaline Reuptake Inhibitors - administration & dosage; ssri-resistant major depressive disorder; Statistics, Nonparametric; Time Factors; Treatment Outcome; vortioxetine; Vortioxetine - administration & dosage; SSRI-resistant major depressive disorder; chart study; real world; Vortioxetine; augmentation; retrospective
• ISSN: 1516-4446; 1809-452X; 1809-452X
• DOI: 10.1590/1516-4446-2019-0690

Selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of treatment of major depressive disorder (MDD). However, non-response is common, often necessitating combination strategies. The present study assessed the efficacy of vortioxetine as an add-on therapy in patients with SSRI-resistant MDD. The charts of 36 adult outpatients with DSM-IV-TR MDD who had not achieved a response after at least 8 weeks of treatment with an SSRI were reviewed retrospectively. Subjects were treated with vortioxetine (5-20 mg/day) for 8 weeks added to the current SSRI. The main outcome measures were change from baseline in total Hamilton Scale for Depression (HAM-D) score and the rate of response (a 50% or greater reduction in HAM-D score and a Clinical Global Impression - Improvement module [CGI-I] score of 1 or 2 at endpoint). HAM-D scores ≤ 7 were considered as remission. Additional outcome measures included the Snaith-Hamilton Pleasure Scale (SHAPS) and the Scale for Suicide Ideation (SSI). 32 patients completed the 8 weeks of treatment. At 8 weeks, a significant reduction in HAM-D score was observed (p ≤ 0.001), with response obtained by 41.7% and remission by 33.3% of patients. Significant reductions in SHAPS and SSI were also observed (p ≤ 0.001 for both scales). Adjunctive vortioxetine may be useful and well-tolerated in stage I treatment-resistant depression. However, the limitations of this study (such as small sample size, absence of randomization and control group, retrospective design, etc.) must be considered.