A “Real-World” Chart Review Study of Monotherapy and Adjunctive Vortioxetine in Clinical Practice

Background: Vortioxetine is a novel antidepressant drug that proved effective in the treatment of major depressive disorder (MDD) and anxiety disorder. It is a unique antidepressant having a multimodal serotonergic mechanism of action and also has important effects on other neurotransmitters implicated in the neurobiology of depression. Keeping in mind the sparse literature on vortioxetine from India, this real-world chart review was conducted to assess its utility and effectiveness. Materials and methods: This is a multicentric retrospective chart analysis of all patients who were prescribed vortioxetine in outpatient psychiatric clinics set in urban areas. Patients prescribed the drug between January 1, 2019, and December 31, 2019, were included in the study. The chart review included details regarding the reason for starting vortioxetine, dosage, side effects observed, duration, and adjunctive medications that the patient had. Descriptive statistics were used in the analysis and the data were presented. Results: The chart review had data of 131 patients. Of these, 85 patients are still maintained on vortioxetine. Majority of the subjects suffered from a MDD. Other indications for the use of vortioxetine included anxiety disorders, obsessive-compulsive disorders, and borderline personality disorder. Only 12 patients suffered side effects which were minor. Majority of the patients reported good improvement with the drug and cost of the drug was a major deterrent to continuing long-term treatment with the drug. Conclusions: Vortioxetine was found to be efficacious with minimal side effects. It may improve cognition in depression and has a lower incidence of treatment-emergent sexual dysfunction. Further data from diverse patient populations are needed before we comment on its effectiveness and safety.