Vortioxetine is a novel antidepressant with effects on multiple 5-HT receptors and on the serotonin transporter. This paper reviews preclinical and clinical evidence regarding its mechanism of action, its tolerability, and its efficacy in treating major depression. Clinical studies indicate that vortioxetine is effective in the treatment of major depression, though there is no suggestion of superiority over active comparators. There may be a clinically meaningful advantage in terms of tolerability.

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SummaryIdentifying the causes of psychiatric and physical symptoms in asylum seekers, refugees and other migrants and making definitive diagnoses can be challenging. Ethical and legal challenges in the UK include the likely deterrent effects of upfront charging for National Health Service (NHS) services. This paper focuses on the fictitious case of an asylum seeker presenting to a mental health service in England, highlighting some of the difficulties in assessing and treating this patient group and providing advice to clinicians on clinical and practical management. Current NHS entitlements for migrants are summarised and a list is presented in the online supplement of non-governmental organisations that can provide further support.

-Background and Objectives: Tourette's Syndrome (TS) is a common developmental neuropsychiatric disorder; people with TS are vulnerable to stigmatization. Public attitudes to TS have seldom been studied. This study examines knowledge of and attitudes to TS and to epilepsy in healthcare students, in an attempt to explore and compare the stigma which might be attached to the two conditions.Methods: Questionnaire survey of healthcare students at one UK medical school.Results: 94 students responded. Though more students knew someone with epilepsy than someone with TS (57% vs 15%; p<0.0001), they were more likely to know a public figure with TS (37% vs 12%; p<0.0001). Among medical students, a higher proportion has seen someone showing evidence of TS (63%) than had seen anyone having a fit (43%; p<0.05). As many as 26% of medical students would object to having a son or daughter of theirs marry a person with TS and 19% of people would object to the marriage of one of their children to a person with epilepsy.Conclusions: The majority of healthcare students had some familiarity with and did not have negative attitudes towards people with TS. However there is still some degree of stigmatization towards both conditions. There remains scope for education in this area as well as for extending such survey research on TS to the general population. Study limitations include the small sample size, and the fact that healthcare students are unrepresentative of broader public opinion.

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