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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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