Subject: A retrospective, cross-sectional observational survey study to analyse the role of Vortioxetine in patients with depression having cognitive deficits.
Major depressive disorder (MDD) is a debilitating disease that is characterized by at least one discrete depressive episode lasting at least 2 weeks and involving clear-cut changes in mood, interests and pleasure, changes in cognition and vegetative symptoms.1 The number of incident cases of depression worldwide increased from 172 million in 1990 to 258 million in 2017, representing an increase of 49.86%.2 In 2017, 197•3 million people had mental disorders in India, including 45•7 million with depressive disorders and 44•9 million with anxiety disorders.3
Neurocognitive impairment is a relevant factor in the quality of life of patients, as it is negatively associated with psychosocial functioning in MDD.4
Treatment options for management of depression can be broadly divided into antidepressants, electroconvulsive therapy (ECT) and psychosocial interventions. In general, because of the side effect and safety profile, selective serotonin reuptake inhibitors (SSRIs) are considered to be the first line antidepressants. Other preferred options include tricyclic antidepressants, mirtazapine, bupropion, and venlafaxine.
In the past two decades, there have been efforts to develop antidepressant drugs that are not monoamine-based, that are devoid of some of the untoward effects of these drugs and that are able to induce clinical changes in a much more rapid manner. Vortioxetine, desvenlafaxine, levomilnacipran, and vilazodone are examples of new-generation antidepressants. These new drugs may become the first choice of antidepressant medication for first-time users as well as a new option for patients whose treatment with older drugs has not been successful.
Vortioxetine is one of the new antidepressants with multimodal activity. It is the first mixed serotonin agonist and antagonist antidepressant.5 It is available as 5 mg, 10 mg and 20 mg tablets administered once daily orally. It has different functional activities at different 5-HT neuronal elements including blockade of serotonin transporter (SERT), agonism of 5-HT1A receptor, and antagonism of 5-HT3 and 5-HT7 receptors.6 These additional serotonin receptor targets differentiate vortioxetine from other SSRIs and SNRIs, and may confer unique clinical benefits for symptomatic improvement in MDD patients.
In line with the cognition-enhancing profile in preclinical studies, vortioxetine was superior to placebo on various cognitive function measures in MDD patients. The efficacy of vortioxetine in MDD patients with an inadequate response to SSRI or SNRI monotherapy also potentially supports a different mechanism of action. In a review article, it was seen that acute and chronic administration of vortioxetine improves performance on objective measures that cover a broad range of cognitive domains making Vortioxetine a promising treatment for treatment of cognitive impairment in MDD7
Vortidif (Vortioxetine) tablets are marketed by Sun Pharmaceutical Industries Ltd. Although every product is marketed only after regulatory approval, it is important to know how it performs in day-to-day practice of individual medical practitioners. For this purpose, we have planned to conduct a retrospective, cross-sectional, observational survey to assess the role of vortioxetine in patients with depression having cognitive deficits.
We invite you to participate in this data collection activity. All you need to do is to report on a standard form your experience with Vortioxetine in the normal course of your practice. If you agree to participate, you will need to fill data collection forms (which we call DCF).
We trust you and we are partners in promoting effective drug therapy with favourable tolerability. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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