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Effect of vortioxetine in subjects with major depressive and alcohol use disorders: a 6-month retrospective analysis

Published online by Cambridge University Press:  10 August 2020

Marco Di Nicola Open the ORCID record for Marco Di Nicola [Opens in a new window] ,
Maria Pepe ,
Isabella Panaccione ,
Lorenzo Moccia ,
Luigi Dattoli ,
Marzia Molinaro ,
Gabriele Sani ,
Luigi Janiri  and
Roger S. McIntyre Open the ORCID record for Roger S. McIntyre [Opens in a new window]
Marco Di Nicola*
Affiliation:
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Maria Pepe
Affiliation:
Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Isabella Panaccione
Affiliation:
Mental Health Department, ASL Roma 1, Rome, Italy
Lorenzo Moccia
Affiliation:
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Luigi Dattoli
Affiliation:
Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Marzia Molinaro
Affiliation:
Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Gabriele Sani
Affiliation:
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Luigi Janiri
Affiliation:
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy Department of Neuroscience, Section of Psichiatry, Università Cattolica del Sacro Cuore, Rome, Italy
Roger S. McIntyre
Affiliation:
Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada Brain and Cognition Discovery Foundation, Toronto, Canada
*
*Author for correspondence: Marco Di Nicola, MD, PhD, Email: [email protected]
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Abstract

Background

Major depressive disorder (MDD) and alcohol use disorder (AUD) are highly comorbid, with greater clinical complexity and psychosocial impairment. Several antidepressants have been used in this population, with mixed results. This preliminary study aims to investigate the effects of the multimodal antidepressant vortioxetine in MDD + AUD subjects.

Methods

We retrospectively evaluated 57 MDD + AUD and 56 MDD outpatients, matched for baseline characteristics. Patients were assessed after 1, 3, and 6 months treatment with vortioxetine (10-20 mg/d, flexibly dosed) in combination with continuous psychosocial support. The primary outcome was improvement in depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale. We also investigated changes in anxiety, anhedonia, cognition, functioning, quality of life, and clinical global severity using the following instruments: Hamilton Anxiety Rating Scale, Snaith-Hamilton Pleasure Scale, Digit Symbol Substitution Test, Perceived Deficits Questionnaire-Depression, Functioning Assessment Short Test, Quality of Life Index, and Clinical Global Impression-Severity Scale.

Results

Vortioxetine significantly improved mood in MDD + AUD patients (P < .001), with no differences when compared to MDD (P = .36). A substantial rate (45.6%) of comorbid subjects obtained clinical remission at endpoint (P = .36 vs MDD). We additionally observed baseline to endpoint improvements on all secondary outcomes (P < .001), with no significant difference between groups. Overall, vortioxetine was safe and well tolerated.

Conclusions

Given its effectiveness on mood, cognition, and functioning, its good safety and tolerability profile, and low potential for abuse, vortioxetine could represent a valid pharmacological intervention in MDD + AUD patients as part of an integrated therapeutic-rehabilitation program.

Keywords

Depressionalcoholismcomorbiditydisabilitypersonalized medicine
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 1 , February 2022 , pp. 73 - 81
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Murray, CJ, Barber, RM, Foreman, KJ, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–2191.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. . Arlington, VA: American Psychiatric Association; 2013.Google Scholar
World Health Organization. Depression and Other Common Mental Disorders: Global Health Estimates. Geneva, Switzerland: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.Google Scholar
Wittchen, HU, Jacobi, F, Rehm, J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–679.CrossRefGoogle ScholarPubMed
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2016 (GBD 2016) Cause-Specific Mortality 1980–2016. Seattle, WA: Institute for Health Metrics and Evaluation (IHME); 2017.Google Scholar
Kohn, R, Saxena, S, Levav, I, et al. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–866.Google ScholarPubMed
Schuckit, MA. Alcohol-use disorders. Lancet. 2009;373(9662):492–501.CrossRefGoogle ScholarPubMed
Merkx, MJM, Schippers, GM, Koeter, MWJ, et al. Guidelines for allocating outpatient alcohol abusers to levels of care: predictive validity. Addict Behav. 2011;36(6):570–575.CrossRefGoogle ScholarPubMed
Guglielmo, R, Martinotti, G, Quatrale, M, et al. Topiramate in alcohol use disorders: review and update. CNS Drugs. 2015;29(5):383–395.CrossRefGoogle ScholarPubMed
Gilman, SE, Abraham, HD. A longitudinal study of the order of onset of alcohol dependence and major depression. Drug Alcohol Depend. 2001;63(3):277–286.CrossRefGoogle ScholarPubMed
Grant, BF, Saha, TD, Ruan, WJ, et al. Epidemiology of DSM-5 drug use disorder: results from the national epidemiologic survey on alcohol and related conditions-III. JAMA Psychiatry. 2016;73(1):39–47.CrossRefGoogle ScholarPubMed
Schneider, B. Substance use disorders and risk for completed suicide. Arch Suicide Res. 2009;13(4):303–316.CrossRefGoogle ScholarPubMed
McHugh, RK, Weiss, RD. Alcohol use disorder and depressive disorders. Alcohol Res. 2019;40(1):arcr.v40.1.01 CrossRefGoogle ScholarPubMed
Helle, AC, Trull, TJ, Watts, AL, et al. Psychiatric comorbidity as a function of severity: dsm-5 alcohol use disorder and hitop classification of mental disorders. Alcohol Clin Exp Res. 2020;44(3):632–644.CrossRefGoogle ScholarPubMed
National Institute for Health & Clinical Excellence. Alcohol Use Disorders: The NICE Guidelines on Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence. The British Psychological Society and The Royal College of Psychiatrists; 2011. http://www.nice.org.uk/guidance/cg115/evidence/full-guideline-136423405. London, UK. Last accessed: February 12, 2020.Google Scholar
The American Psychiatric Association. Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder. 2017. https://psychiatryonline.org/doi/book/10.1176/appi.books.9781615371969. American Psychiatric Association Publishing, Arlington, VA. Last accessed: February 12, 2020.Google Scholar
Iovieno, N, Tedeschini, E, Bentley, KH, et al. Antidepressants for major depressive disorder and dysthymic disorder in patients with comorbid alcohol use disorders: a meta-analysis of placebo-controlled randomized trials. J Clin Psychiatry. 2011;72(8):1144–1151.CrossRefGoogle ScholarPubMed
Foulds, JA, Adamson, SJ, Boden, JM, et al. Depression in patients with alcohol use disorders: systematic review and meta-analysis of outcomes for independent and substance-induced disorders. J Affect Disord. 2015;185:47–59.CrossRefGoogle ScholarPubMed
Agabio, R, Trogu, E, Pani, PP. Antidepressants for the treatment of people with co-occurring depression and alcohol dependence. Cochrane Database Syst Rev. 2018;4:CD008581 Google ScholarPubMed
Strid, C, Hallgren, M, Forsell, Y, et al. Changes in alcohol consumption after treatment for depression: a secondary analysis of the Swedish randomised controlled study REGASSA. BMJ Open. 2019;9(11):e028236 CrossRefGoogle ScholarPubMed
Cipriani, A, Furukawa, TA, Salanti, G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357–1366.CrossRefGoogle ScholarPubMed
McIntyre, RS, Lee, Y, Mansur, RB. Treating to target in major depressive disorder: response to remission to functional recovery. CNS Spectr. 2015;20(Suppl 1):20–31.CrossRefGoogle ScholarPubMed
Baune, BT, Sluth, LB, Olsen, CK. The effects of vortioxetine on cognitive performance in working patients with major depressive disorder: a short-term, randomized, double-blind, exploratory study. J Affect Disord. 2018;229:421–428.CrossRefGoogle ScholarPubMed
Cao, B, Park, C, Subramaniapillai, M, et al. The efficacy of vortioxetine on anhedonia in patients with major depressive disorder. Front Psychiatry. 2019;10:17 CrossRefGoogle ScholarPubMed
Subramaniapillai, M, Mansur, RB, Zuckerman, H, et al. Association between cognitive function and performance on effort based decision making in patients with major depressive disorder treated with vortioxetine. Compr Psychiatry. 2019;94:152113 CrossRefGoogle ScholarPubMed
Pehrson, AL, Cremers, T, Bétry, C, et al. Lu AA21004, a novel multimodal antidepressant, produces regionally selective increases of multiple neurotransmitters—a rat microdialysis and electrophysiology study. Eur Neuropsychopharmacol. 2013;23(2):133–145.CrossRefGoogle ScholarPubMed
Chen, G, Nomikos, GG, Affinito, J, et al. Lack of effect of vortioxetine on the pharmacokinetics and pharmacodynamics of ethanol, diazepam, and lithium. Clin Pharmacokinet. 2016;55(9):1115–1127.CrossRefGoogle ScholarPubMed
Orsolini, L, Tomasetti, C, Valchera, A, et al. Current and future perspectives on the major depressive disorder: focus on the new multimodal antidepressant vortioxetine. CNS Neurol Disord Drug Targets. 2017;16(1):65–92.CrossRefGoogle ScholarPubMed
First, MB, Williams, JBW, Karg, RS, et al. Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV). Arlington, VA: American Psychiatric Association; 2016.Google Scholar
First, MB, Williams, JBW, Benjamin, LS, et al. Structured Clinical Interview for DSM-5 Personality Disorder. Arlington, VA: American Psychiatric Association; 2015.Google Scholar
Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–389.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198.CrossRefGoogle ScholarPubMed
Riedel, M, Möller, HJ, Obermeier, M, et al. Response and remission criteria in major depression--a validation of current practice. J Psychiatr Res. 2010;44(15):1063–1068.CrossRefGoogle ScholarPubMed
Durgam, S, Chen, C, Migliore, R, et al. Relapse prevention with levomilnacipran ER in adults with major depressive disorder: a multicenter, randomized, double-blind, placebo-controlled study. Depress Anxiety. 2019;36(3):225–234.CrossRefGoogle ScholarPubMed
Hamilton, M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50–55.CrossRefGoogle ScholarPubMed
Guy, W. Clinical global impression. In: ECDEU Assessment Manual for Psychopharmacology, revised (DHEW Publ. No. ADM 76-338). Rockville, MD: National Institute of Mental Health; 1976:218–222.Google Scholar
Snaith, RP, Hamilton, M, Morley, S, et al. A scale for the assessment of hedonic tone the Snaith-Hamilton pleasure scale. Br J Psychiatry. 1995;167(1):99–103.CrossRefGoogle ScholarPubMed
Franken, IH, Rassin, E, Muris, P. The assessment of anhedonia in clinical and non-clinical populations: further validation of the Snaith-Hamilton pleasure scale (SHAPS). J Affect Disord. 2007;99(1–3):83–89.CrossRefGoogle Scholar
Wechsler, D. Wechsler Adult Intelligence Scale. 3rd ed. . San Antonio, TX: Psychological Corporation; 1997.Google Scholar
Lam, RW, Lamy, FX, Danchenko, N, et al. Psychometric validation of the perceived deficits questionnaire-depression (PDQ-D) instrument in US and UK respondents with major depressive disorder. Neuropsychiatr Dis Treat. 2018;14:2861–2877.CrossRefGoogle ScholarPubMed
McIntyre, RS, Harrison, J, Loft, H, et al. The effects of vortioxetine on cognitive function in patients with major depressive disorder: a meta-analysis of three randomized controlled trials. Int J Neuropsychopharmacol. 2016;19(10):pyw055 CrossRefGoogle ScholarPubMed
Rosa, AR, Sánchez-Moreno, J, Martínez-Aran, A, et al. Validity and reliability of the functioning assessment short test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health. 2007;3:5 CrossRefGoogle Scholar
Spitzer, WO, Dobson, AJ, Hall, J, et al. Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis. 1981;34(12):585–597.CrossRefGoogle ScholarPubMed
Hunt, GE, Malhi, GS, Lai, HMX, et al. Prevalence of comorbid substance use in major depressive disorder in community and clinical settings, 1990–2019: systematic review and meta-analysis. J Affect Disord. 2020;266:288–304.CrossRefGoogle ScholarPubMed
Boden, JM, Fergusson, DM. Alcohol and depression. Addiction. 2011;106(5):906–914.CrossRefGoogle ScholarPubMed
Grant, BF, Goldstein, RB, Saha, TD, et al. Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry. 2015;72(8):757–766.CrossRefGoogle ScholarPubMed
Hasin, DS, Sarvet, AL, Meyers, JL, et al. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the united states. JAMA Psychiatry. 2018;75(4):336–346.CrossRefGoogle ScholarPubMed
Boschloo, L, van den Brink, W, Penninx, BW, et al. Alcohol-use disorder severity predicts first-incidence of depressive disorders. Psychol Med. 2012;42(4):695–703.CrossRefGoogle ScholarPubMed
Blow, FC, Serras, AM, Barry, KL. Late-life depression and alcoholism. Curr Psychiatry Rep. 2007;9(1):14–19.CrossRefGoogle ScholarPubMed
Almeida, OP, Hankey, GJ, Yeap, BB, et al. The triangular association of ADH1B genetic polymorphism, alcohol consumption and the risk of depression in older men. Mol Psychiatry. 2014;19(9):995–1000.CrossRefGoogle ScholarPubMed
Cheng, HG, Chen, S, McBride, O, et al. Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: results from the China health and retirement longitudinal study (CHARLS). J Affect Disord. 2016;195:136–143.CrossRefGoogle Scholar
Andersen, AM, Pietrzak, RH, Kranzler, HR, et al. Polygenic scores for major depressive disorder and risk of alcohol dependence. JAMA Psychiatry. 2017;74(11):1153–1160.CrossRefGoogle ScholarPubMed
Foo, JC, Streit, F, Treutlein, J, et al. Shared genetic etiology between alcohol dependence and major depressive disorder. Psychiatr Genet. 2018;28(4):66–70.CrossRefGoogle ScholarPubMed
Otten, R, van der Zwaluw, CS, Engels, RC. Testing bidirectional relationships between alcohol use and depressive symptoms: what is the role of the serotonin transporter gene. Alcohol. 2018;66:69–75.CrossRefGoogle ScholarPubMed
Destoop, M, Morrens, M, Coppens, V, et al. Addiction, anhedonia, and comorbid mood disorder. a narrative review. Front Psychiatry. 2019;10:311 CrossRefGoogle ScholarPubMed
Riga, D, Schmitz, LJM, van Mourik, Y, et al. Stress vulnerability promotes an alcohol-prone phenotype in a preclinical model of sustained depression. Addict Biol. 2020;25(1):e12701.CrossRefGoogle Scholar
Shin, SH, Ksinan Jiskrova, G, Yoon, SH, et al. Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms. [published online ahead of print, 2020 Feb 26]. Am J Drug Alcohol Abuse. 2020;1–9.Google ScholarPubMed
McEachin, RC, Keller, BJ, Saunders, EF, et al. Modeling gene-by-environment interaction in comorbid depression with alcohol use disorders via an integrated bioinformatics approach. BioData Min. 2008;1(1):2 CrossRefGoogle ScholarPubMed
Di Nicola, M, Moccia, L, Ferri, VR, et al. Alcoholism in bipolar disorders: an overview of epidemiology, common pathogenetic pathways, course of disease, and implications for treatment. In: Preedy, VR ed. Neuroscience of Alcohol. London, UK: Academic Press; 2019:363–371.CrossRefGoogle Scholar
Iasevoli, F, Valchera, A, Di Giovambattista, E, et al. Affective temperaments are associated with specific clusters of symptoms and psychopathology: a cross-sectional study on bipolar disorder inpatients in acute manic, mixed, or depressive relapse. J Affect Disord. 2013;151(2):540–550.CrossRefGoogle ScholarPubMed
Janiri, D, Di Nicola, M, Martinotti, G, et al. Who’s the leader, mania or depression? Predominant polarity and alcohol/polysubstance use in bipolar disorders. Curr Neuropharmacol. 2017;15(3):409–416.CrossRefGoogle ScholarPubMed
Di Nicola, M, Pepe, M, Modica, M, et al. Mixed states in patients with substance and behavioral addictions. Psychiatr Clin North Am. 2020;43(1):127–137.CrossRefGoogle ScholarPubMed
Mandelli, L, Mazza, M, Di Nicola, M, et al. Role of substance abuse comorbidity and personality on the outcome of depression in bipolar disorder: harm avoidance influences medium-term treatment outcome. Psychopathology. 2012;45(3):174–178.CrossRefGoogle ScholarPubMed
Zaninotto, L, Souery, D, Calati, R, et al. Temperament and character profiles in bipolar I, bipolar II and major depressive disorder: Impact over illness course, comorbidity pattern and psychopathological features of depression. J Affect Disord. 2015;184:51–59.CrossRefGoogle ScholarPubMed
Han, KM, De Berardis, D, Fornaro, M, et al. Differentiating between bipolar and unipolar depression in functional and structural MRI studies. Prog Neuropsychopharmacol Biol Psychiatry. 2019;91:20–27.CrossRefGoogle ScholarPubMed
Hong, M, Ha, TH, Lee, S, et al. Clinical correlates of alcohol use disorder in depressed patients with unipolar and bipolar disorder. Psychiatry Investig. 2019;16(12):926–932.CrossRefGoogle ScholarPubMed
Pettinati, HM, O’Brien, CP, Dundon, WD. Current status of co-occurring mood and substance use disorders: a new therapeutic target. Am J Psychiatry. 2013;170(1):23–30.CrossRefGoogle ScholarPubMed
Bang-Andersen, B, Ruhland, T, Jørgensen, M, et al. Discovery of 1-[2-(2,4-dimethylphenylsulfanyl)phenyl]piperazine (Lu AA21004): a novel multimodal compound for the treatment of major depressive disorder. J Med Chem. 2011;54(9):3206–3221.CrossRefGoogle ScholarPubMed
Caraci, F, Di Sciascio, G. Multi-modality as a new pharmacological approach for treatment of depression: the role of vortioxetine. Ital J Psychopathol. 2015;21:210–223.Google Scholar
McIntyre, RS, Lophaven, S, Olsen, CK. A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults. Int J Neuropsychopharmacol. 2014;17(10):1557–1567.CrossRefGoogle ScholarPubMed
Baune, BT, Brignone, M, Larsen, KG. A network meta-analysis comparing effects of various antidepressant classes on the digit symbol substitution test (DSST) as a measure of cognitive dysfunction in patients with major depressive disorder. Int J Neuropsychopharmacol. 2018;21(2):97–107.CrossRefGoogle ScholarPubMed
Christensen, MC, Loft, H, McIntyre, RS. Vortioxetine improves symptomatic and functional outcomes in major depressive disorder: a novel dual outcome measure in depressive disorders. J Affect Disord. 2018;227:787–794.CrossRefGoogle ScholarPubMed
Davis, LL, Wisniewski, SR, Howland, RH, et al. Does comorbid substance use disorder impair recovery from major depression with SSRI treatment? An analysis of the STAR*D level one treatment outcomes. Drug Alcohol Depend. 2010;107(2–3):161–170.CrossRefGoogle ScholarPubMed
Di Nicola, M, De Risio, L, Battaglia, C, et al. Reduced hedonic capacity in euthymic bipolar subjects: a trait-like feature. J Affect Disord. 2013;147(1–3):446–450.CrossRefGoogle ScholarPubMed
Vinckier, F, Gourion, D, Mouchabac, S. Anhedonia predicts poor psychosocial functioning: results from a large cohort of patients treated for major depressive disorder by general practitioners. Eur Psychiatry. 2017;44:1–8.CrossRefGoogle ScholarPubMed
Martinotti, G, Di Nicola, M, Reina, D, et al. Alcohol protracted withdrawal syndrome: the role of anhedonia. Subst Use Misuse. 2008;43(3–4):271–284.CrossRefGoogle ScholarPubMed
Martinotti, G, Andreoli, S, Reina, D, et al. Acetyl-l-Carnitine in the treatment of anhedonia, melancholic and negative symptoms in alcohol dependent subjects. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(4):953–958.CrossRefGoogle ScholarPubMed
Cano, MÁ, de Dios, MA, Correa-Fernández, V, et al. Depressive symptom domains and alcohol use severity among Hispanic emerging adults: examining moderating effects of gender. Addict Behav. 2017;72:72–78.CrossRefGoogle ScholarPubMed
Garfield, JB, Lubman, DI, Yücel, M. Anhedonia in substance use disorders: a systematic review of its nature, course and clinical correlates. Aust N Z J Psychiatry. 2014;48(1):36–51.CrossRefGoogle ScholarPubMed
Pettorruso, M, Martinotti, G, Fasano, A, et al. Anhedonia in Parkinson’s disease patients with and without pathological gambling: a case-control study. Psychiatry Res. 2014;215(2):448–452.CrossRefGoogle ScholarPubMed
Carton, L, Pignon, B, Baguet, A, et al. Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: a general population-based study. Drug Alcohol Depend. 2018;187:40–47.CrossRefGoogle ScholarPubMed
Lu, Y, Ho, CS, McIntyre, RS, et al. Effects of vortioxetine and fluoxetine on the level of brain derived neurotrophic factors (BDNF) in the hippocampus of chronic unpredictable mild stress-induced depressive rats. Brain Res Bull. 2018;142:1–7.CrossRefGoogle ScholarPubMed
Staples, MC, Mandyam, CD. Thinking after drinking: impaired hippocampal-dependent cognition in human alcoholics and animal models of alcohol dependence. Front Psychiatry. 2016;7:162 CrossRefGoogle ScholarPubMed
D’Hondt, F, Lescut, C, Maurage, P, et al. Psychiatric comorbidities associated with a positive screening using the Montreal Cognitive Assessment (MoCA) test in subjects with severe alcohol use disorder. Drug Alcohol Depend. 2018;191:266–269.CrossRefGoogle ScholarPubMed
Bétry, C, Etiévant, A, Pehrson, A, et al. Effect of the multimodal acting antidepressant vortioxetine on rat hippocampal plasticity and recognition memory. Prog Neuropsychopharmacol Biol Psychiatry. 2015;58:38–46.CrossRefGoogle ScholarPubMed
Riga, MS, Sánchez, C, Celada, P, et al. Involvement of 5-HT3 receptors in the action of vortioxetine in rat brain: Focus on glutamatergic and GABAergic neurotransmission. Neuropharmacology. 2016;108:73–81.CrossRefGoogle ScholarPubMed
Sanchez, C, Asin, KE, Artigas, F. Vortioxetine, a novel antidepressant with multimodal activity: review of preclinical and clinical data. Pharmacol Ther. 2015;145:43–57.CrossRefGoogle ScholarPubMed