A Feasibility Study of Patients with Major Depression and Substance Use Disorders: Vortioxetine as Maintenance Treatment

Abstract

Ignacio Basurte-Villamor,1 Pablo Vega,2 Carlos Roncero,3– 5 José Martínez-Raga,6 Lara Grau-López,7– 10 Lourdes Aguilar,3– 5 Marta Torrens,11 Nestor Szerman12 1Department of Psychiatry and Behavioral Health, Clínica López Ibor, Madrid, Spain; 2Institute for Addictions, Madrid Salud, Madrid City Council, Madrid, Spain; 3Department of Psychiatry, University of Salamanca Healthcare Complex, Salamanca, Spain; 4Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain; 5Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain; 6Department of Psychiatry and Clinical Psychology, University Hospital Dr. Peset and University of Valencia, Valencia, Spain; 7Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain; 8Biomedical Network Research Centre on Mental Health, CIBERSAM, Barcelona, Spain; 9Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute, Barcelona, Spain; 10Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; 11Institute of Neuropsychiatry & Addictions-Hospital del Mar, Barcelona IMIM, Hospital del Mar Medical Research Institute, Barcelona University Autònoma, Barcelona, Spain; 12WADD WPA Section Dual Disorders, Mental Health and Psychiatric Institute, Gregorio Marañon University Hospital, Madrid, SpainCorrespondence: Nestor Szerman, WADD WPA Section Dual Disorders, Mental Health and Psychiatric Institute, Gregorio Marañon University Hospital, C/ Lope de Rueda 43, Madrid, 28009, Spain, Tel [phone], Fax [phone], Email [email protected]: Limited studies have evaluated the effectiveness of vortioxetine in real-world settings, and none of them has involved patients with dual depression (major depressive disorder [MDD] and substance use disorder [SUD]). The objective of the study was to describe the effectiveness of vortioxetine in clinical practice and determine its effect on affective symptoms, cognitive function, quality of life, and substance use in patients with MDD and SUD.Methods: Post-authorization, retrospective, multicenter, descriptive, and observational study in 80 patients with MDD and SUD receiving a maintenance treatment with vortioxetine for six months between January 2017 and April 2021.Results: Compared with baseline, scores significantly decreased after 3 and 6 months of treatment in the Montgomery-Åsberg Depression Rating Scale total (from 28.9 to 17.7 and 12.0), and global functional impairment of the Sheehan Disability Inventory (from 26.3 to 19.1 and 16.7). The number of correct answers in the symbol digit modalities test significantly improved during vortioxetine treatment (from 40.4 to 43.8 and 48.4). Regarding the clinical global impression scale, the score for disease severity significantly decreased from 3.8 to 3.0 and 2.4. Compared with baseline, there was a significant reduction in consumption of practically all substances, especially of alcohol, cannabis, and cocaine.Conclusion: Vortioxetine was effective in clinical practice for alleviating depressive symptoms and functional impairment, and in improving cognitive and executive functions and disease severity in patients with MDD and SUD. Moreover, the treatment with vortioxetine favored a reduction in substance use and the severity of the SUDs.Keywords: vortioxetine, major depressive disorder, substance use disorder, dual disorder, major dual depressive disorder, real-world evidence

Keywords

• vortioxetine
• major depressive disorder
• substance use disorder
• dual disorder
• major dual depressive disorder
• real-world evidence