Application of vortioxetine in outpatients with endogenous depression

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The study aimed to evaluate the clinical action, safety, and tolerability of vortioxetine in outpatients with depressive conditions.

Material and methods. An open comparative study of patients with various nosological forms of endogenous depressive conditions (depressive episodes, recurrent depressive disorder, and bipolar affective disorder) was conducted. The course of therapy with vortioxetine in a daily dose of 10–20 mg lasted 42 days. Methods of clinical and psychometric evaluation of the results were used as well as correlation analysis using Spearman’s coefficient. The severity and degree of reduction in depressive and anxiety symptoms were recorded using the Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Clinical Global Impression–Disease Severity Scale (CGI-S). To assess the severity of adverse side effects, the side effects rating scale (UKU) was used.

Results. Vortioxetine has been found to be an effective antidepressant. At the end of therapy, a reduction in the mean total score on the HAM-D scale by more than 50% was registered in 92.2% of patients. Furthermore, 76.3% of patients had a therapeutic effect with a reduction in the mean total scores of the HAM-D scale by more than 80%. The reduction in mean scores on the HAM-A scale by day 28 reached 87.25%. According to the CGI-S scale values, 68.4% of patients completed the course of therapy with complete remission. Significant direct correlations were found between the daily drug dose and disease duration and the initial depressive symptom severity. A correlation between the anxiety level and vortioxetine dose was observed in all stages of therapy. The depression level on days 7 and 21 correlated with the dose size, starting from week 3. The adverse event severity detected in most cases ranged from mild to moderate.

Conclusion. Thymoanaleptic and anxiolytic activities provide vortioxetine with efficacy in various nosological forms of endogenous depression. For conditions with a longer duration and severity of the disease, a higher dosage of vortioxetine (20 mg/day) is required. During therapy, vortioxetine has demonstrated a favorable safety and tolerability profile; therefore, it can be used in an outpatient basis.

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About the authors

Victoriya Yu. Krylatykh

Center for Psychosomatic Medicine and Psychotherapy

Author for correspondence.
ORCID iD: 0000-0002-3583-6962

врач-психиатр, ООО «Центр психосоматической медицины и психотерапии»

Russian Federation, 119415, Moscow


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Supplementary files

Supplementary Files
1. Рис. 1. Степень выраженности терапевтического эффекта вортиоксетина при эндогенной депрессии.

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2. Рис. 2. Динамика депрессивных симптомов, оцененных по шкале Гамильтона для оценки депрессии (HAM-D).

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3. Рис. 3. Динамика тревожных симптомов, оцененных по шкале Гамильтона для оценки тревоги (HAM-А).

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4. Рис. 4. Редукция средних суммарных баллов шкалы Гамильтона для оценки тревоги (HAM-А) и шкалы Гамильтона для оценки депрессии (HAM-D).

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5. Рис. 5. Редукция средних баллов шкалы Гамильтона для оценки депрессии (HAM-D) в группе больных с депрессивными эпизодами и шизотипическим расстройством.

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6. Рис. 6. Редукция средних баллов шкалы Гамильтона для оценки тревоги (HAM-А) в группе больных с аффективными расстройствами и шизотипическим расстройством.

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7. Рис. 7. Тяжесть депрессивного состояния по шкале общего клинического впечатления CGI-S до и после лечения.

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