New advances in the treatment of generalized anxiety disorder: the multimodal antidepressant vortioxetine

  title={New advances in the treatment of generalized anxiety disorder: the multimodal antidepressant vortioxetine},
  author={Laura Orsolini and Carmine Tomasetti and Alessandro Valchera and Felice Iasevoli and Elisabetta Filomena Buonaguro and Federica Vellante and Michele Fornaro and Annastasia L C Fiengo and Monica Mazza and Roberta Vecchiotti and Giampaolo Robert Perna and Andrea de Bartolomeis and Giovanni Martinotti and Massimo Di Giannantonio and Domenico de Berardis},
  journal={Expert Review of Neurotherapeutics},
  pages={483 - 495}
Generalized Anxiety Disorder (GAD) is a persistent condition characterized by chronic anxiety, exaggerated worry and tension, mainly comorbid with Major Depressive Disorder (MDD. [] Key Result Only two studies, of which one prevention relapse trial, reported a significant improvement in anxiety symptomatology compared to three with negative findings.

Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review

An algorithmic approach to the pediatric and adult patient with GAD is described and considerations for the use of selected medications in these patients are highlighted.

Panic disorder: A review of treatment options.

  • M. Ziffra
  • Psychology, Medicine
    Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 2021
Treatments with the strongest evidence include SSRIs, other antidepressants, and CBT, and newer interventions approved for the treatment of depression, such as serotonin multimodal agents, esketamine, and rTMS merit further investigation.

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

Adjunctive vortioxetine may be useful and well-tolerated in stage I treatment-resistant depression, and the limitations of this study (such as small sample size, absence of randomization and control group, retrospective design, etc.) must be considered.

Novel Pathways in the Treatment of Major Depression: Focus on the Glutamatergic System.

The most advanced knowledge on the involvement of glutamatergic system in the molecular mechanisms at the basis of depression pathophysiology are discussed, as well as the glutamate-based therapeutic strategies currently suggested to optimize depression treatment (e.g., ketamine).

An open-label, flexible dose adaptive study evaluating the efficacy of vortioxetine in subjects with panic disorder

Some support for the use of vortioxetine in the management of panic disorder is provided, with a statistically significant decrease in the occurrence of panic attacks and a moderate improvement in the quality of life.

Modulation of the Serotonergic Receptosome in the Treatment of Anxiety and Depression: A Narrative Review of the Experimental Evidence

This review presents the experimental evidence of the modulation of the “serotonergic receptosome” in the treatment of anxiety and depression, as well as demonstrating state-of-the-art research related to phytochemicals and these disorders.

Relative short‐term efficacy and acceptability of agomelatine versus vortioxetine in adult patients suffering from major depressive disorder

An adjusted indirect comparison using placebo as a common control found no difference in efficacy or acceptability of agomelatine compared to vortioxetine in adult patients with major depressive disorder.

Can Long-Term Pharmacotherapy Prevent Relapses in Generalized Anxiety Disorder? A Systematic Review

Long-term pharmacotherapy may prevent symptom relapse in GAD patients and as the relapse rate is very high, the data support the continuation of pharmacotherapy for as long as possible.

Preclinical characterization of ACH-000029, a novel anxiolytic compound acting on serotonergic and alpha-adrenergic receptors

Pharmacological management of post-stroke depression: an update of the evidence and clinical guidance

Although there are still gaps in knowledge of PSD, the seriousness should not be neglected, and pharmacological treatment should be recommended when relevant, and close follow-up and dose adjustments as well as add-on possibilities are important aspects of treatment.



Vortioxetine: a review of efficacy, safety and tolerability with a focus on cognitive symptoms in major depressive disorder

Vortioxetine is the first antidepressant agent to demonstrate meaningful clinical efficacy in the improvement of cognition in adults with MDD, independent of improvement in affective symptomatology.

Evidence-based pharmacological treatment of generalized anxiety disorder.

It is difficult to predict reliably which patients will respond well to pharmacological treatment, but response to antidepressants is unlikely if there is no evidence of an onset of effect within 4 wk, and continuing treatment for at least 12 months is recommended.

Vortioxetine, a multimodal antidepressant for generalized anxiety disorder: a systematic review and meta-analysis.

Sumatriptan (5-HT1D receptor agonist) does not exacerbate symptoms in obsessive compulsive disorder

No indication were found for the role of the 5-HTID receptor in the pathophysiology of OCD, and it should be noted, however, that sumatriptan does not readily pass the blood-brain barrier.

Anxiogenic effects of Sumatriptan in panic disorder: A double-blind, placebo-controlled study

Sumatriptan, 5-HT1D receptors and obsessive-compulsive disorder

Treatment-emergent sexual dysfunction in randomized trials of vortioxetine for major depressive disorder or generalized anxiety disorder: a pooled analysis

Vortioxetine was associated with rates of TESD that were not significantly different from placebo in short-term clinical trials, and changes in ASEX individual item scores supported the similarity of vortoxetine doses to placebo.

Vortioxetine: First Global Approval

Animal and in vitro studies indicate that several neurotransmitter systems may be impacted by vortioxetine, with the drug enhancing levels of 5-HT, noradrenaline, dopamine, acetylcholine and histamine in certain areas of the brain, as well as modulating γ-aminobutyric acid and glutamate neurotransmission.

Lu AA21004, a multimodal psychotropic agent, in the prevention of relapse in adult patients with generalized anxiety disorder

In this study, Lu AA21004 5 or 10 mg/day was efficacious in preventing relapse and was well tolerated in the maintenance treatment of GAD.