Efficacy and safety of levomilnacipran, vilazodone and vortioxetine compared with other second-generation antidepressants for major depressive disorder in adults: A systematic review and network meta-analysis

Wagner, Gernot; Schultes, Marie-Thérèse; Titscher, Viktoria; Teufer, Birgit; Klerings, Irma; Gartlehner, Gerald

doi:10.1016/j.jad.2017.11.056

Cited by 47 publications

(19 citation statements)

References 27 publications

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“…Epileptic seizures were observed in 1% of MDD patients without a known epileptic history in the efficacy studies of vortioxetine. Therefore, it is advised that vortioxetine should be used cautiously in patients with epilepsy 10,11 . However, the effect of vortioxetine on epileptic seizures is not precisely known.…”

Section: Introductionmentioning

confidence: 99%

The effect of vortioxetine on penicillin-induced epileptiform activity in rats

Öğün

Çetinkaya

Beyazçiçek

2019

Arq. Neuro-Psiquiatr.

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Vortioxetine is a multimodal antidepressant agent that modulates 5-HT receptors and inhibits the serotonin transporter. It is indicated especially in cases of major depressive disorder related to cognitive dysfunction. There are many studies investigating the effects of antidepressants on the seizure threshold and short-term epileptic activity. However, the effect of vortioxetine on epileptic seizures is not exactly known. Our aim was to investigate the effects of vortioxetine on penicillin-induced epileptiform activity. Twenty-seven Wistar rats were divided into three groups: sham-control group, positive control group (diazepam), and vortioxetine group. After a penicillin-induced epilepsy model was formed in each of the three groups of animals, 0.1 ml of saline was administered to the control group, 0.1 ml (10 mg/kg) vortioxetine was administered in the vortioxetine group, and 0.1 mL (5 mg/kg) of diazepam was administered in the positive control group, intraperitoneally. The epileptic activity records were obtained for 120 minutes after the onset of seizure. There was no significant difference in spike wave activity between the vortioxetine and diazepam groups, whereas this was significantly reduced in the vortioxetine group compared with the controls. The administration of vortioxetine at a dose of 10 mg/kg immediately after the seizure induction significantly decreased the spike frequencies of epileptiform activity compared with the control group. No significant difference was found between the vortioxetine and positive controls. This study showed that vortioxetine reduces the number of acutely-induced epileptic discharges. Vortioxetine may be an important alternative for epileptic patients with major depressive disorder-related cognitive dysfunction.

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Section: Introductionmentioning

confidence: 99%

The effect of vortioxetine on penicillin-induced epileptiform activity in rats

Öğün

Çetinkaya

Beyazçiçek

2019

Arq. Neuro-Psiquiatr.

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“… 98 99 However, in the other RCT, significantly more patients treated with vortioxetine experienced nausea (37.5% vs. 16.7%; RR 2.25, 95% CI 1.12–4.53) than patients treated with paroxetine. 97 Although the studies reported here only included RCT, with its primary aim as investigating the efficacy and tolerability of vortioxetine and vilazodone with placebo rather than comparator, the available evidence does not indicate fewer negative effects of vilazodone and vortioxetine as compared with other second-generation antidepressants.…”

Section: Safety Of Even Newer Recently Fda Approved Drugs: Multimodalmentioning

confidence: 94%

“…However, significantly more patients treated with vilazodone experienced diarrhea (26.5% vs. 10.6%; RR 2.49, 95% CI 1.69–3.67) and vomiting (6.6% vs. 1.8%; RR 3.73, 95% CI 1.41–9.86) than patients treated with citalopram. 96 97 …”

Section: Safety Of Even Newer Recently Fda Approved Drugs: Multimodalmentioning

confidence: 99%

Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review

et al. 2018

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Randomized trials have shown that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have better safety profiles than classical tricyclic antidepressants (TCAs). However, an increasing number of studies, including meta-analyses, naturalistic studies, and longer-term studies suggested that SSRIs and SNRIs are no less safe than TCAs. We focused on comparing the common side effects of TCAs with those of newer generation antidepressants including SSRIs, SNRIs, mirtazapine, and bupropion. The main purpose was to investigate safety profile differences among drug classes rather than the individual antidepressants, so studies containing comparison data on drug groups were prioritized. In terms of safety after overdose, the common belief on newer generation antidepressants having fewer side effects than TCAs appears to be true. TCAs were also associated with higher drop-out rates, lower tolerability, and higher cardiac side-effects. However, evidence regarding side effects including dry mouth, gastrointestinal side effects, hepatotoxicity, seizure, and weight has been inconsistent, some studies demonstrated the superiority of SSRIs and SNRIs over TCAs, while others found the opposite. Some other side effects such as sexual dysfunction, bleeding, and hyponatremia were more prominent with either SSRIs or SNRIs.

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“…Although the mechanism of action of ketamine (Zanos and Gould, 2018;Deyama and Duman, 2020;McIntyre et al, 2020) differs substantially from that of standard antidepressants (Feighner, 1999;Patel et al, 2017), it might be hypothesized that they share common target areas that therefore could be involved in the etiology of depression. This hypothesis might be considered to explain the antidepressant effect produced by selective serotonin reuptake inhibitor (SSRIs), and by selective norepinephrine reuptake inhibitor (SNRI), which, although acting on two different transmission systems, can produce equivalent antidepressant effects (Artigas, 2015;Gałecki et al, 2018;Wagner et al, 2018). In addition to the brain areas discussed above, the bed nucleus of stria terminalis (BNST) should be considered as a target of antidepressant action.…”

Section: Role Of Bnst In the Antidepressant Effect Of Ketamine And Standard Antidepressantsmentioning

confidence: 99%

Repurposing Ketamine in Depression and Related Disorders: Can This Enigmatic Drug Achieve Success?

et al. 2021

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Repurposing ketamine in the therapy of depression could well represent a breakthrough in understanding the etiology of depression. Ketamine was originally used as an anesthetic drug and later its use was extended to other therapeutic applications such as analgesia and the treatment of addiction. At the same time, the abuse of ketamine as a recreational drug has generated a concern for its psychotropic and potential long-term effects; nevertheless, its use as a fast acting antidepressant in treatment-resistant patients has boosted the interest in the mechanism of action both in psychiatry and in the wider area of neuroscience. This article provides a comprehensive overview of the actions of ketamine and intends to cover: (i) the evaluation of its clinical use in the treatment of depression and suicidal behavior; (ii) the potential use of ketamine in pediatrics; (iii) a description of its mechanism of action; (iv) the involvement of specific brain areas in producing antidepressant effects; (v) the potential interaction of ketamine with the hypothalamic-pituitary-adrenal axis; (vi) the effect of ketamine on neuronal transmission in the bed nucleus of stria terminalis and on its output; (vii) the evaluation of any gender-dependent effects of ketamine; (viii) the interaction of ketamine with the inflammatory processes involved in depression; (ix) the evaluation of the effects observed with single or repeated administration; (x) a description of any adverse or cognitive effects and its abuse potential. Finally, this review attempts to assess whether ketamine’s use in depression can improve our knowledge of the etiopathology of depression and whether its therapeutic effect can be considered an actual cure for depression rather than a therapy merely aimed to control the symptoms of depression.

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Efficacy and safety of levomilnacipran, vilazodone and vortioxetine compared with other second-generation antidepressants for major depressive disorder in adults: A systematic review and network meta-analysis

Cited by 47 publications

References 27 publications

The effect of vortioxetine on penicillin-induced epileptiform activity in rats

The effect of vortioxetine on penicillin-induced epileptiform activity in rats

Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review

Repurposing Ketamine in Depression and Related Disorders: Can This Enigmatic Drug Achieve Success?

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