Vortioxetine: A Review in Cognitive Dysfunction in Depression

Vortioxetine (Brintellix^®; Trintellix^®), a generally efficacious and well tolerated antidepressant agent, is approved in the EU and USA for the treatment of major depressive disorder (MDD) in adults. The drug has a distinctive pharmacological profile (combining inhibition of the serotonin transporter with modulation of multiple serotonin receptors) and has been shown to enhance cognitive performance in various animal models and clinical trials. Across three large, placebo-controlled studies in adults with recurrent MDD, short-term treatment with vortioxetine almost always resulted in statistically significant and clinically meaningful improvements in performance on two objective measures (the Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test) that together cover a broad range of cognitive domains, including executive function, attention, processing speed, learning and memory. Vortioxetine also significantly improved a subjective measure of cognitive function (the Perceived Deficits Questionnaire) and an objective measure of functional capacity (the University of San Diego performance-based skills assessment). In general, the beneficial effects of vortioxetine on these measures were largely independent of its effect on improving depressive symptoms. Based on the available data, therefore, vortioxetine is a useful treatment option in patients with MDD where impaired cognitive function is apparent.