title: Current and Future Perspectives on the Major Depressive Disorder: Focus on the New Multimodal Antidepressant Vortioxetine.
abstract: Vortioxetine (VRX) is a multimodal antidepressant that acts as serotonin (5HT) transporter inhibitor as well as 5HT3A and 5HT7 receptors antagonist, 5HT1A and 5HT1B receptors partial agonist. It was recently approved in the US and the EU for the treatment of adult patients with Major Depressive Disorder (MDD).
  
  
  
  The present article aims at systematically reviewing findings of the published and unpublished research on the pharmacological properties, efficacy, safety and tolerability of oral VRX in the treatment of MDD.
  
  
  
  A systematic review, in accordance with the Cochrane Collaboration and the PRISMA guidelines, was conducted searching the electronic databases MEDLINE, by combining the following keyterms: ((vortioxetine OR LU AA21004 OR brintellix) AND (antidepressant OR depression OR major depressive disorder), without language/time restrictions. Further studies were retrieved from reference listing of relevant articles or manual search. Preclinical and clinical studies (RCT and open label trials) were here retrieved.
  
  
  
  Several placebo-controlled and active-treatment studies demonstrated the antidepressant efficacy and tolerability of VRX in adult patients affected with MDD. In addition, VRX seems to own procognitive activity. VRX seems generally well tolerated, without significant cardiovascular or weight gain effects. The most common adverse events reported included nausea, vomiting, hyperhidrosis, headache, dizziness, somnolence, diarrhoea and dry mouth.
  
  
  
  Overall, placebo controlled and active treatment trials support that VRX is effective and well tolerated in MDD. Its combined serotonin reuptake inhibition with agonism, partial agonism and antagonism of a number of receptors might provide a broader spectrum of antidepressant activity than currently available agents.
authors: Laura
authors: L
authors: Orsolini
authors: Carmine
authors: C
authors: Tomasetti
authors: Alessandro
authors: A
authors: Valchera
authors: Felice
authors: F
authors: Iasevoli
authors: Elisabetta Filomena
authors: EF
authors: Buonaguro
authors: Michele
authors: M
authors: Fornaro
authors: Annastasia L C
authors: ALC
authors: Fiengo
authors: Giovanni
authors: G
authors: Martinotti
authors: Federica
authors: F
authors: Vellante
authors: Ilaria
authors: I
authors: Matarazzo
authors: Roberta
authors: R
authors: Vecchiotti
authors: Giampaolo
authors: G
authors: Perna
authors: Marco
authors: M
authors: Di Nicola
authors: Alessandro
authors: A
authors: Carano
authors: Andrea
authors: A
authors: Di Bartolomeis
authors: Massimo
authors: M
authors: De Giannantonio
authors: National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo,. Italy.
authors: Domenico
authors: D
authors: De Berardis
mesh_terms: D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D014179:Neurotransmitter Uptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013440:Sulfides / Q000494:pharmacology / Q000627:therapeutic use*; D000078784:Vortioxetine
chemical_list: D000928:Antidepressive Agents; D014179:Neurotransmitter Uptake Inhibitors; D010879:Piperazines; D017367:Selective Serotonin Reuptake Inhibitors; D013440:Sulfides; D000078784:Vortioxetine
keywords: Antidepressant; Lu AA21004; brintellix; depression; major depressive disorder; multimodal; vortioxetine.