The efficacy of vortioxetine for the treatment of major depressive disorder

Abstract

Vortioxetine (Lu AA21004; Brintellix^®) has received approval from various international regulatory agencies for the treatment of major depression. The drug molecule has a multimodal mechanism of action that projects it as a unique molecule for the treatment of major depression. These mechanisms include property to inhibit serotonin reuptake via inhibiting serotonin transporters and acting on multiple serotonin receptor subtypes. Vortioxetine is an agonist of 5-HT1A, a partial agonist of 5-HT1B and an antagonist of 5-HT1D, 5-HT3 and 5-HT7 serotoninergic receptors. The molecule has been found to be effective and well-tolerable to be administered in humans for the treatment of major depression. Precautions should be exercised when vortioxetine is prescribed with cytochrome P450 inducers and inhibitors. This review attempts to compile the efficacy profile of vortioxetine in different clinical trials and the results are compared with other standard antidepressants.

Keywords::

• Brintellix^®
• clinical studies
• efficacy and safety
• Lu AA21004
• major depression
• serotonin receptors
• serotonin transporters
• vortioxetine

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Major depression is a severe mood disorder that requires therapeutic intervention.

• Various antidepressants are available in the market that could provide relief in 60–70% patients. However, a large subset of depressed patients continue to have symptoms despite the availability of these antidepressant agents.

• Therefore, there is a need to develop novel antidepressant molecules with unique mechanism of action.

• Vortioxetine is a novel antidepressant that has been approved by the US FDA in 2013. The molecule is unique in the context that it has multimodal mechanism of action.

• Vortioxetine is an agonist of 5-HT1A, a partial agonist of 5-HT1B and an antagonist of 5-HT1D, 5-HT3 and 5-HT7 serotoninergic receptors.

• The molecule is efficacious for the treatment of major depression. The antidepressant dose ranges from 5 to 20 mg/day. Moreover, it has a better safety profile in terms of sexual dysfunctions compared with other antidepressants. However, precaution should be taken before these molecules are prescribed with cytochrome P450 inducers and inhibitors.Vortioxetine also need a lag period of approximately 4 weeks before it starts showing its antidepressant effect.Such molecules are useful antidepressants for the treatment of major depression.

Notes