Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a ''real-world'' chart review study

Adjunctive vortioxetine for SSRI-resistant major
depressive disorder: a ‘‘real-world’’ chart review study

Objective: Selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of treatment of major
depressive disorder (MDD). However, non-response is common, often necessitating combination
strategies. The present study assessed the efficacy of vortioxetine as an add-on therapy in patients
with SSRI-resistant MDD.
Methods: The charts of 36 adult outpatients with DSM-IV-TR MDD who had not achieved a response
after at least 8 weeks of treatment with an SSRI were reviewed retrospectively. Subjects were treated
with vortioxetine (5-20 mg/day) for 8 weeks added to the current SSRI. The main outcome measures
were change from baseline in total Hamilton Scale for Depression (HAM-D) score and the rate of
response (a 50% or greater reduction in HAM-D score and a Clinical Global Impression - Improvement
module [CGI-I] score of 1 or 2 at endpoint). HAM-D scores p 7 were considered as remission.
Additional outcome measures included the Snaith-Hamilton Pleasure Scale (SHAPS) and the Scale
for Suicide Ideation (SSI).
Results: 32 patients completed the 8 weeks of treatment. At 8 weeks, a significant reduction in HAM-D
score was observed (p p 0.001), with response obtained by 41.7% and remission by 33.3% of
patients. Significant reductions in SHAPS and SSI were also observed (p p 0.001 for both scales).
Conclusions: Adjunctive vortioxetine may be useful and well-tolerated in stage I treatment-resistant
depression. However, the limitations of this study (such as small sample size, absence of
randomization and control group, retrospective design, etc.) must be considered.