Real-world effectiveness of vortioxetine in outpatients with major depressive disorder: functioning and dose effects

Background Functional recovery is an important treatment goal in major depressive disorder (MDD). This study assessed the real-world effectiveness of vortioxetine in patients with MDD, with particular focus on functioning; dose-response was also assessed. Methods This was a non-interventional, prospective, multicenter study conducted in Greece. Adult outpatients with MDD (n = 336) initiating vortioxetine (5-20 mg/day flexible dosing) as treatment for a current major depressive episode were followed for 3 months. Analyses were stratified according to vortioxetine dosage at 3 months: 5-10 mg/day versus 15-20 mg/day. Functioning was assessed using the Sheehan Disability Scale (SDS). Results Mean [+ or -] standard error SDS total score decreased (improved) from 18.7 [+ or -] 0.3 at baseline to 12.9 [+ or -] 0.3 after 1 month of vortioxetine treatment and 7.8 [+ or -] 0.4 after 3 months (p < 0.001 vs. baseline for all comparisons). Functional recovery (SDS score [less than or equai to] 6) was achieved in 14.6% of patients after 1 month of treatment and 48.4% of patients after 3 months. Improvement from baseline in SDS total and domain scores at 3 months was more pronounced in patients receiving vortioxetine 15-20 mg/day than in those receiving vortioxetine 5-10 mg/day. The mean [+ or -] standard error change in SDS total score from baseline was 9.2 [+ or -] 0.8 in the 5-10 mg/day group and 12.1 [+ or -] 0.4 in the 15-20 mg/day group (p < 0.001). Limitations of this study include its non-interventional study design and lack of a control group or active comparator. Conclusions Statistically significant and clinically relevant improvements in functioning were seen in patients with MDD treated with vortioxetine in a real-world setting. Higher doses of vortioxetine were associated with significantly greater improvements in functioning. Keywords: Major depressive disorder (MDD), Functioning, Vortioxetine, Real-world effectiveness, Dose-response