Vortioxetine improves depressive symptoms, cognitive performance, functioning and health-related quality of life in patients with both major depressive disorder and early-stage dementia, according to a recent trial.
In a significant proportion of patients, depressive symptoms and dementia are related. However, there is insufficient evidence to support the use of antidepressants to treat depression in patients with dementia. Despite this, a recent meta-analysis suggested that the antidepressant, vortioxetine could help patients with major depressive disorder (MDD) recover cognitive function. Whether vortioxetine is able to provide similar benefits in patients with MDD and comorbid early stage dementia is unclear.
For the present study, published in the Journal of Affective Disorders, a team of Spanish and Danish researchers, investigated the effectiveness of vortioxetine at improving depressive symptoms, cognitive performance, functioning and health-related quality of life in patients with both MDD and early-onset dementia.
Eligible patients were aged 55-85 years and had a primary diagnosis of recurrent MDD, with onset before 55 years of age, and comorbid early-stage dementia diagnosed ≥6 months before screening and after onset of MDD.
Treatment with vortioxetine was started at a dose of 5 mg once daily and up-titrated to 10 mg daily in all patients. The dosage could then be either increased to 20 mg or reduced to 5 mg at the investigator’s discretion. The primary endpoint was change from baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) total score at week 12.
Vortioxetine and depression symptoms
A total of 82 patients with a mean age of 70.3 years (66%) were included in the study and the most common dementia diagnosis was Alzheimer’s disease (43%).
There were statistically significant and clinically meaningful improvements in the severity of depressive symptoms, based on the MADRS total score, seen at all assessment timepoints up to 12 weeks (p < 0.0001). In fact, at week 12, the mean change from baseline was −12.4.
There were also significant improvements in cognitive performance, daily and global functioning and health-related quality of life. Vortioxetine was well tolerated, and from week four, more than half of patients received the 20 mg dose.