Vortioxetine vs. other antidepressants in patients with major depressive episode with or without substance use disorder

Abstract: Background: Major Depressive Episodes (MDEs) may characterise many psychiatric di- sorders. Its pharmacotherapy is laid with unmet needs, rendering the testing of new drugs neces- sary. Objective: To compare the effects of vortioxetine with those of other antidepressants (OADs) in a 1-year naturalistic setting. Methods: We included 126 adult patients with anMDE in the course of major depressive (MDD), bipolar (BD), or schizophrenia spectrum disorders (SSOPDs), with or without substance use disor- der (SUD), who received 5-20 mg/day oral vortioxetine, and compared them with 100 patients re- ceiving OADs at baseline and after 1, 3, 8, and 12 months on their scores on the MADRS, the CGI- S, the 24-item BPRS, the YMRS, the Hamilton Anxiety Rating Scale, a Visual Analogue Scale for craving, the Columbia-Suicide Severity Rating Scale, and the WHOQOL-BREF. Results: Patients on vortioxetine improved similarly to those on OADs on all measures, indepen- dently from having or not a comorbid SUD. However, they improved with time better than their OADcounterparts if affected by BD or SSOPDs, but not MDD, on the CGI-S, BPRS depression, anxiety, and manic symptoms. SUD hampered the response of anxiety to treatment. Men improved on depression with time better than women. Conclusion: MDEs responded to vortioxetine similarly to OADs by improving in depression, gen- eral psychopathology, anxiety, suicidal thinking, and quality-of-life, independently from SUD co- morbidity. MDEs of patients with BD or SSOPDs on vortioxetine responded better than that of pa- tients on OADs. Clinical Trial Registration No. 17354N.