Vortioxetine, a multimodal antidepressant for generalized anxiety disorder

A systematic review and meta-analysis

Chi Un Pae, Sheng Min Wang, Changsu Han, Soo Jung Lee, Ashwin A. Patkar, Praksh S. Masand, Alessandro Serretti

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

Vortioxetine has a beneficial pharmacological profile for reducing anxiety and depression. Recently, a number of randomized, double-blind, placebo-controlled clinical trials (RCTs) of vortioxetine have been conducted in patients with generalized anxiety disorder (GAD); however, the results from GAD RCTs are inconsistent. With an extensive search of databases and clinical trial registries, four published short-term RCTs were identified and included in the present meta-analysis. The mean change in total scores on the Hamilton Anxiety Rating Scale (HAMA) from baseline was the primary endpoint. The secondary endpoints included the response and remission rates, as defined by a ≥50% reduction in HAMA total scores and a ≤7 change in the HAMA total score at the end of treatment. In addition, the mean change in the HAMA total score from baseline in the subgroup with a HAMA total score ≥25 at baseline was included. Vortioxetine was significantly more effective than was placebo, with a standardized mean difference (SMD) of-0.118 (95% CIs,-0.203 to-0.033, P=0.007). In particular, those with severe GAD (HAMA total score ≥25 at baseline) had a significantly greater benefit from vortioxetine than those without (SMD=-0.338, 95% CIs=-0.552 to-0.124, p=0.002). The odds ratios (ORs) for vortioxetine for response and remission were 1.221 (95% CIs, 1.027 to 1.452, P=0.024) and 1.052 (95% CIs, 0.853 to 1.296, P=0.637), respectively. Discontinuation due to adverse events (AEs) (OR=1.560, 1.006 to 2.419, p=0.047) was marginally higher in vortioxetine than placebo treatment, whereas discontinuation due to any reason (OR=0.971, 0.794 to 1.187, p=0.771) and inefficacy (OR=0.687, 0.380 to 1.243, p=0.215) were not significantly different among treatment groups. Although our results suggest that vortioxetine may have a potential as an another treatment option for GAD (especially for severe GAD), they should be interpreted and translated into clinical practice with caution, as the meta-analysis was based on a limited number of RCTs.

Original languageEnglish
Pages (from-to)88-98
Number of pages11
JournalJournal of Psychiatric Research
Volume64
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Anxiety Disorders
Antidepressive Agents
Meta-Analysis
Odds Ratio
Placebos
Anxiety
Controlled Clinical Trials
Therapeutics
vortioxetine
Antidepressants
Meta-analysis
Systematic Review
Registries
Clinical Trials
Databases
Pharmacology
Depression
Randomized Controlled Trial
Placebo

Keywords

  • Efficacy
  • Generalized anxiety disorder
  • Meta-analysis
  • Safety
  • Tolerability
  • Vortioxetine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Vortioxetine, a multimodal antidepressant for generalized anxiety disorder : A systematic review and meta-analysis. / Pae, Chi Un; Wang, Sheng Min; Han, Changsu; Lee, Soo Jung; Patkar, Ashwin A.; Masand, Praksh S.; Serretti, Alessandro.

In: Journal of Psychiatric Research, Vol. 64, 01.05.2015, p. 88-98.

Research output: Contribution to journalReview article

Pae, Chi Un ; Wang, Sheng Min ; Han, Changsu ; Lee, Soo Jung ; Patkar, Ashwin A. ; Masand, Praksh S. ; Serretti, Alessandro. / Vortioxetine, a multimodal antidepressant for generalized anxiety disorder : A systematic review and meta-analysis. In: Journal of Psychiatric Research. 2015 ; Vol. 64. pp. 88-98.
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