Why the study?
Major depressive disorder and generalized anxiety disorder are frequently comorbid, prompting assessment of the effectiveness of vortioxetine in this population.
Does vortioxetine improve symptoms in adult outpatients with severe MDD and severe comorbid GAD?
Does vortioxetine improve symptoms in adult outpatients with severe MDD and severe comorbid GAD?
Vortioxetine is effective and well-tolerated in reducing symptoms of both depression and anxiety in patients with severe MDD comorbid with severe GAD, supporting early up-titration to 20 mg/day.
May support vortioxetine in severe MDD with comorbid GAD; hypothesis-generating and requires RCT confirmation.
BACKGROUND: Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are frequently comorbid. AIMS: To assess the effectiveness of vortioxetine in patients with MDD and comorbid GAD. METHODS: Open-label, 8-week study (NCT04220996) in 100 adult outpatients with severe MDD and severe comorbid GAD receiving vortioxetine as first treatment for the current depressive episode or switching to vortioxetine due to inadequate response to another drug for depression. Vortioxetine starting dosage was 10 mg/day, with forced up-titration to 20 mg/day after 1 week. Response was defined as ⩾50% decrease in Montgomery-Åsberg Depression Rating Scale (MADRS) and/or Hamilton Anxiety Rating Scale (HAM-A) total score from baseline; remission defined as MADRS and/or HAM-A total score ⩽10. RESULTS: < 0.0001 vs baseline). At week 8, rates of MADRS response and remission were 61% and 35%, respectively. Corresponding rates of HAM-A response and remission were 55% and 42%. Response on both the MADRS and HAM-A scales was achieved by 52% of patients; 31% achieved remission on both scales. Vortioxetine dose up-titration was well tolerated; no unexpected adverse events were reported. CONCLUSION: Vortioxetine demonstrates effectiveness in significantly reducing symptoms of both depression and anxiety in patients with severe MDD comorbid with severe GAD. Findings support increasing vortioxetine dosage to 20 mg/day early in the course of therapy, and show that this may be achieved without compromising tolerability.
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Christensen et al. (2022) studied this question.
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