nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2022-5-96-102nnp-1898Research ArticleREVIEWSОБЗОРЫApathy, anhedonia and cognitive dysfunction: common symptoms of depression and neurological disordersАпатия, ангедония и когнитивная дисфункция: общие симптомы депрессии и неврологической патологииhttps://orcid.org/0000-0002-2228-6316ПетелинД. С.PetelinD. S.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

petelinhome1@yandex.ruhttps://orcid.org/0000-0002-8099-2091БайрамоваС. П.BairamovaS. P.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

https://orcid.org/0000-0001-8863-8241СорокинаО. Ю.SorokinaO. Yu.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

https://orcid.org/0000-0003-3088-4321НийнояИ. Н.NiinojaI. N.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

https://orcid.org/0000-0001-9467-6244ЛокшинаА. Б.LokshinaA. B.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

https://orcid.org/0000-0003-1667-5355ВолельБ. А.VolelB. A.

119991, Москва, ул. Большая Пироговская, 2, стр. 4

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation20222510202214596102Copyright © Petelin D.S., Bairamova S.P., Sorokina O.Y., Niinoja I.N., Lokshina A.B., Volel B.A., 20222022Петелин Д.С., Байрамова С.П., Сорокина О.Ю., Нийноя И.Н., Локшина А.Б., Волель Б.А.Petelin D.S., Bairamova S.P., Sorokina O.Y., Niinoja I.N., Lokshina A.B., Volel B.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1898

Depression is one of the most common mental disorders in neurological practice. Among other symptoms of depression, a symptom complex represented by apathy, anhedonia, and cognitive impairment plays an important role. This review presents the clinical characteristics of the symptoms described above and discusses modern neurochemical and neuroimaging concepts of their pathogenesis. The problem of pathogenetically substantiated therapy of depression with a predominance of apathy, anhedonia and cognitive impairment is discussed. Fundamental and clinical arguments are presented in favor of the high efficacy of vortioxetine in depression with a predominance of apathy, anhedonia, and cognitive impairment. 

Депрессии относятся к числу наиболее распространенных психических расстройств в неврологической практике. Среди прочих симптомов депрессии большую роль играет симптомокомплекс, представленный апатией, ангедонией и когнитивными нарушениями (КН). В настоящем обзоре представлена клиническая характеристика описанных выше симптомов, обсуждаются современные нейрохимические и нейровизуализационные представления об их патогенезе. Обсуждается проблема патогенетически обоснованной терапии депрессий с преобладанием апатии, ангедонии и КН. Представлены фундаментальные и клинические аргументы в пользу высокой эффективности вортиоксетина при депрессиях с преобладанием апатии, ангедонии и КН. 

апатияангедониякогнитивные нарушениядепрессиявортиоксетинapathyanhedoniacognitive impairmentdepressionvortioxetineСтатья спонсируется компанией «Лундбек».This article has been supported by Lundbeck RUS LLC.ReferencesГоловачева ВА, Парфенов ВА. Депрессия в неврологической практике: распространенность, диагностика, стандарты лечения и новые возможности фармакотерапии. Медицинский Совет. 2015;(5):55-61. doi: 10.21518/2079-701X-2015-5-55-61.Golovacheva VA, Parfyonov VA. Depression in neurological practice: prevalence, diagnosis, treatment standards and new options for pharmacotherapy. Meditsinskiy sovet = Medical Council. 2015;(5):55-61. doi: 10.21518/2079-701X-2015-5-55-61 (In Russ.).Романов ДВ, Волель БА, Петелин ДС. Подходы к терапии депрессии в неврологии (перспективы применения агомелатина). Неврология, нейропсихиатрия, психосоматика. 2018;10(4):101-10. doi: 10.14412/2074- 2711-2018-4-101-110.Romanov DV, Volel BA, Petelin DS. Approaches to therapy for depressions in neurology: prospects for the use of agomelatine. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):101-10. doi: 10.14412/2074-2711-2018-4-101-110 (In Russ.).Романов ДВ, Петелин ДС, Волель БА. Депрессии в неврологической практике. Медицинский Совет. 2018;(1):38-45. doi: 10.21518/2079-701X-2018-1-38-45.Romanov DV, Petelin DS, Volel BA. Depression in neurological practice. Meditsinskiy sovet = Medical Council. 2018;(1):38-45. doi: 10.21518/2079-701X2018-1-38-45 (In Russ.).Rickards H. Depression in neurological disorders: Parkinson's disease, multiple sclerosis, and stroke. J Neurol Neurosurg Psychiatry. 2005 Mar;76 Suppl 1:i48-52. doi: 10.1136/jnnp.2004.060426Rickards H. Depression in neurological disorders: Parkinson's disease, multiple sclerosis, and stroke. J Neurol Neurosurg Psychiatry. 2005 Mar;76 Suppl 1:i48-52. doi: 10.1136/jnnp.2004.060426Vrieze E, Demyttenaere K, Bruffaerts R, et al. Dimensions in major depressive disorder and their relevance for treatment outcome. J Affect Disord. 2014 Feb;155:35-41. doi: 10.1016/j.jad.2013.10.020Vrieze E, Demyttenaere K, Bruffaerts R, et al. Dimensions in major depressive disorder and their relevance for treatment outcome. J Affect Disord. 2014 Feb;155:35-41. doi: 10.1016/j.jad.2013.10.020Vares EA, Salum GA, Spanemberg L, et al. Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients. PLoS One. 2015 Aug 27;10(8):e0136037. doi: 10.1371/journal.pone.0136037Vares EA, Salum GA, Spanemberg L, et al. Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients. PLoS One. 2015 Aug 27;10(8):e0136037. doi: 10.1371/journal.pone.0136037Сорокин СА. Эндогенные апатические депрессии (вопросы психопатологии, клиники и терапии): Дис. … канд. мед. наук. Москва; 2015. 196 p.Sorokin SA. Endogennyye apaticheskiye depressii (voprosy psikhopatologii, kliniki i terapii): Dis. … kand. med. nauk [Endogenous apathetic depressions (issues of psychopathology, clinic and therapy): Dis. … cand. med. sci]. Moscow; 2015. 196 p. (In Russ.).Lanctot KL, Agüera-Ortiz L, Brodaty H, et al. Apathy associated with neurocognitive disorders: Recent progress and future directions. Alzheimers Dement. 2017 Jan;13(1):84- 100. doi: 10.1016/j.jalz.2016.05.008Lanctot KL, Agüera-Ortiz L, Brodaty H, et al. Apathy associated with neurocognitive disorders: Recent progress and future directions. Alzheimers Dement. 2017 Jan;13(1):84- 100. doi: 10.1016/j.jalz.2016.05.008Husain M, Roiser JP. Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nat Rev Neurosci. 2018 Aug;19(8):470-84. doi: 10.1038/s41583-018- 0029-9Husain M, Roiser JP. Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nat Rev Neurosci. 2018 Aug;19(8):470-84. doi: 10.1038/s41583-018- 0029-9Fahed M, Steffens DC. Apathy: Neurobiology, Assessment and Treatment. Clin Psychopharmacol Neurosci. 2021 May 31;19(2):181-9. doi: 10.9758/cpn.2021.19.2.181Fahed M, Steffens DC. Apathy: Neurobiology, Assessment and Treatment. Clin Psychopharmacol Neurosci. 2021 May 31;19(2):181-9. doi: 10.9758/cpn.2021.19.2.181Yuen GS, Bhutani S, Lucas BJ, et al. Apathy in late-life depression: common, persistent, and disabling. Am J Geriatr Psychiatry. 2015 May;23(5):488-94. doi: 10.1016/j.jagp.2014.06.005Yuen GS, Bhutani S, Lucas BJ, et al. Apathy in late-life depression: common, persistent, and disabling. Am J Geriatr Psychiatry. 2015 May;23(5):488-94. doi: 10.1016/j.jagp.2014.06.005Lenze EJ, Skidmore ER, Dew MA, et al. Does depression, apathy or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? Gen Hosp Psychiatry. 2007 Mar-Apr;29(2):141- 6. doi: 10.1016/j.genhosppsych.2007.01.001Lenze EJ, Skidmore ER, Dew MA, et al. Does depression, apathy or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? Gen Hosp Psychiatry. 2007 Mar-Apr;29(2):141- 6. doi: 10.1016/j.genhosppsych.2007.01.001Le Heron C, Holroyd CB, Salamone J, Husain M. Brain mechanisms underlying apathy. J Neurol Neurosurg Psychiatry. 2019 Mar;90(3):302-12. doi: 10.1136/jnnp-2018- 318265Le Heron C, Holroyd CB, Salamone J, Husain M. Brain mechanisms underlying apathy. J Neurol Neurosurg Psychiatry. 2019 Mar;90(3):302-12. doi: 10.1136/jnnp-2018- 318265Cooper JA, Arulpragasam AR, Treadway MT. Anhedonia in depression: biological mechanisms and computational models. Curr Opin Behav Sci. 2018 Aug;22:128-35. doi: 10.1016/j.cobeha.2018.01.024Cooper JA, Arulpragasam AR, Treadway MT. Anhedonia in depression: biological mechanisms and computational models. Curr Opin Behav Sci. 2018 Aug;22:128-35. doi: 10.1016/j.cobeha.2018.01.024Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011 Jan;35(3):537-55. doi: 10.1016/j.neubiorev.2010.06.006. Epub 2010 Jul 11.Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011 Jan;35(3):537-55. doi: 10.1016/j.neubiorev.2010.06.006. Epub 2010 Jul 11.Der-Avakian A, Markou A. The neurobiology of anhedonia and other reward-related deficits. Trends Neurosci. 2012 Jan;35(1):68-77. doi: 10.1016/j.tins.2011.11.005Der-Avakian A, Markou A. The neurobiology of anhedonia and other reward-related deficits. Trends Neurosci. 2012 Jan;35(1):68-77. doi: 10.1016/j.tins.2011.11.005Касимова ЛН, Святогор МВ. Ангедония в структуре аффективных расстройств: возможности терапии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019;119(11):116-22. doi: 10.17116/jnevro2019119111116.Kasimova LN, Svyatogor MV. Angedonia in the structure of affective disorders: therapeutic opportunities. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(11):116-22. doi: 10.17116/jnevro2019119111116 (In Russ.).Chong TT, Husain M. The role of dopamine in the pathophysiology and treatment of apathy. Prog Brain Res. 2016;229:389-426. doi: 10.1016/bs.pbr.2016.05.007. Epub 2016 Jul 29.Chong TT, Husain M. The role of dopamine in the pathophysiology and treatment of apathy. Prog Brain Res. 2016;229:389-426. doi: 10.1016/bs.pbr.2016.05.007. Epub 2016 Jul 29.Hezemans FH, Wolpe N, O'Callaghan C, et al. Noradrenergic deficits contribute to apathy in Parkinson's disease through the precision of expected outcomes. PLoS Comput Biol. 2022 May 9;18(5):e1010079. doi: 10.1371/journal.pcbi.1010079Hezemans FH, Wolpe N, O'Callaghan C, et al. Noradrenergic deficits contribute to apathy in Parkinson's disease through the precision of expected outcomes. PLoS Comput Biol. 2022 May 9;18(5):e1010079. doi: 10.1371/journal.pcbi.1010079Pecina M, Karp JF, Mathew S, et al. Endogenous opioid system dysregulation in depression: implications for new therapeutic approaches. Mol Psychiatry. 2019 Apr;24(4):576-87. doi: 10.1038/s41380-018- 0117-2Pecina M, Karp JF, Mathew S, et al. Endogenous opioid system dysregulation in depression: implications for new therapeutic approaches. Mol Psychiatry. 2019 Apr;24(4):576-87. doi: 10.1038/s41380-018- 0117-2McIntyre RS, Woldeyohannes HO, Soczynska JK, et al. Anhedonia and cognitive function in adults with MDD: results from the International Mood Disorders Collaborative Project. CNS Spectr. 2016 Oct;21(5):362-6. doi: 10.1017/S1092852915000747McIntyre RS, Woldeyohannes HO, Soczynska JK, et al. Anhedonia and cognitive function in adults with MDD: results from the International Mood Disorders Collaborative Project. CNS Spectr. 2016 Oct;21(5):362-6. doi: 10.1017/S1092852915000747Montoya-Murillo G, Ibarretxe-Bilbao N, Pena J, Ojeda N. The impact of apathy on cognitive performance in the elderly. Int J Geriatr Psychiatry. 2019 May;34(5):657-65. doi: 10.1002/gps.5062Montoya-Murillo G, Ibarretxe-Bilbao N, Pena J, Ojeda N. The impact of apathy on cognitive performance in the elderly. Int J Geriatr Psychiatry. 2019 May;34(5):657-65. doi: 10.1002/gps.5062Ахапкин РВ, Маслова МА. Когнитивные нарушения при непсихотических депрессивных расстройствах. Российский психиатрический журнал. 2015;(1):43-50.Akhapkin RV, Maslova MA. Cognitive impairments in non-psychotic depressive disorders. Rossiyskiy psikhiatricheskiy zhurnal = Russian Journal of Psychiatry. 2015;(1):43-50 (In Russ.).Knight MJ, Mills NT, Baune BT. Contemporary methods of improving cognitive dysfunction in clinical depression. Expert Rev Neurother. 2019 May;19(5):431-43. doi: 10.1080/14737175.2019.1610395. Epub 2019 Apr 25.Knight MJ, Mills NT, Baune BT. Contemporary methods of improving cognitive dysfunction in clinical depression. Expert Rev Neurother. 2019 May;19(5):431-43. doi: 10.1080/14737175.2019.1610395. Epub 2019 Apr 25.Knight MJ, Baune BT. Cognitive dysfunction in major depressive disorder. Curr Opin Psychiatry. 2018 Jan;31(1):26-31. doi: 10.1097/YCO.0000000000000378Knight MJ, Baune BT. Cognitive dysfunction in major depressive disorder. Curr Opin Psychiatry. 2018 Jan;31(1):26-31. doi: 10.1097/YCO.0000000000000378Lam RW, Kennedy SH, Mclntyre RS, Khullar A. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry. 2014 Dec;59(12):649-54. doi: 10.1177/070674371405901206Lam RW, Kennedy SH, Mclntyre RS, Khullar A. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry. 2014 Dec;59(12):649-54. doi: 10.1177/070674371405901206Park C, Pan Z, Brietzke E, et al. Predicting antidepressant response using early changes in cognition: A systematic review. Behav Brain Res. 2018 Nov 1;353:154-60. doi: 10.1016/j.bbr.2018.07.011Park C, Pan Z, Brietzke E, et al. Predicting antidepressant response using early changes in cognition: A systematic review. Behav Brain Res. 2018 Nov 1;353:154-60. doi: 10.1016/j.bbr.2018.07.011Jones RD, Tranel D, Benton A, Paulsen J. Differentiating dementia from “pseudodementia” early in the clinical course: utility of neuropsychological tests. Neuropsychology. 1992;6(1):13-21. doi: 10.1037/0894-4105.6.1.13Jones RD, Tranel D, Benton A, Paulsen J. Differentiating dementia from “pseudodementia” early in the clinical course: utility of neuropsychological tests. Neuropsychology. 1992;6(1):13-21. doi: 10.1037/0894-4105.6.1.13Berrios GE. “Depressive pseudodementia” or “Melancholic dementia”: a 19th century view. J Neurol Neurosurg Psychiatry. 1985 May;48(5):393-400. doi: 10.1136/jnnp.48.5.393Berrios GE. “Depressive pseudodementia” or “Melancholic dementia”: a 19th century view. J Neurol Neurosurg Psychiatry. 1985 May;48(5):393-400. doi: 10.1136/jnnp.48.5.393Saez-Fonseca JA, Lee L, Walker Z. Longterm outcome of depressive pseudodementia in the elderly. J Affect Disord. 2007 Aug;101(1- 3):123-9. doi: 10.1016/j.jad.2006.11.004Saez-Fonseca JA, Lee L, Walker Z. Longterm outcome of depressive pseudodementia in the elderly. J Affect Disord. 2007 Aug;101(1- 3):123-9. doi: 10.1016/j.jad.2006.11.004Sekhon S, Marwaha R. Depressive Cognitive Disorders. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559256/Sekhon S, Marwaha R. Depressive Cognitive Disorders. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559256/Kendrick T, Peveler R. Guidelines for the management of depression: NICE work? Br J Psychiatry. 2010 Nov;197(5):345-7. doi: 10.1192/bjp.bp.109.074575Kendrick T, Peveler R. Guidelines for the management of depression: NICE work? Br J Psychiatry. 2010 Nov;197(5):345-7. doi: 10.1192/bjp.bp.109.074575Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013 Jul;14(5):334-85. doi: 10.3109/15622975.2013.804195. Epub 2013 Jul 3.Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013 Jul;14(5):334-85. doi: 10.3109/15622975.2013.804195. Epub 2013 Jul 3.Российское общество психиатров. Клинические рекомендации. Рекуррентное депрессивное расстройство, диагностика и лечение. Москва; 2014.Rossiyskoye obshchestvo psikhiatrov. Klinicheskiye rekomendatsii. Rekurrentnoye depressivnoye rasstroystvo, diagnostika i lecheniye [Russian Society of Psychiatrists. Clinical guidelines. Recurrent depressive disorder, diagnosis and treatment]. Moscow; 2014 (In Russ.).Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. Br J Psychiatry. 2009 Sep;195(3):211-7. doi: 10.1192/bjp.bp.108.051110Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. Br J Psychiatry. 2009 Sep;195(3):211-7. doi: 10.1192/bjp.bp.108.051110Padala PR, Padala KP, Majagi AS, et al. Selective serotonin reuptake inhibitors-associated apathy syndrome: A cross sectional study. Medicine (Baltimore). 2020 Aug 14;99(33):e21497. doi: 10.1097/MD.0000000000021497Padala PR, Padala KP, Majagi AS, et al. Selective serotonin reuptake inhibitors-associated apathy syndrome: A cross sectional study. Medicine (Baltimore). 2020 Aug 14;99(33):e21497. doi: 10.1097/MD.0000000000021497Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004 May;10(3):196-9. doi: 10.1097/00131746-200405000-00010Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004 May;10(3):196-9. doi: 10.1097/00131746-200405000-00010Петрова НН, Маркин АВ. Синдром апатии у депрессивных пациентов, получавших лечение селективными ингибиторами обратного захвата серотонина. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020;120(1):111-7. doi: 10.17116/jnevro2020120011111.Petrova NN, Markin AV. Apathy syndrome in depressed patients previously treated with selective serotonin reuptake inhibitors. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2020;120(1):111-7. doi: 10.17116/jnevro2020120011111 (In Russ.).Fava M, Graves LM, Benazzi F, et al. A cross-sectional study of the prevalence of cognitive and physical symptoms during long-term antidepressant treatment. J Clin Psychiatry. 2006 Nov;67(11):1754-9. doi: 10.4088/jcp.v67n1113Fava M, Graves LM, Benazzi F, et al. A cross-sectional study of the prevalence of cognitive and physical symptoms during long-term antidepressant treatment. J Clin Psychiatry. 2006 Nov;67(11):1754-9. doi: 10.4088/jcp.v67n1113Петелин ДС, Гамирова АН, Воскресенская ОН, Волель БА. СИОЗС-ассоциированная апатия при болезни Альцгеймера: серия клинических наблюдений. Неврология, нейропсихиатрия, психосоматика. 2022;14(4):51-3. doi: 10.14412/2074-2711-2022-4-51-53.Petelin DS, Gamirova AN, Voskresenskaya ON, Volel BA. SSRI-associated apathy in Alzheimer's disease: a case series. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(4):51-3. doi: 10.14412/2074-2711-2022-4-51-53 (In Russ.).McCabe C, Mishor Z, Cowen PJ, Harmer CJ. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol Psychiatry. 2010 Mar 1;67(5):439-45. doi: 10.1016/j.biopsych.2009.11.001McCabe C, Mishor Z, Cowen PJ, Harmer CJ. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol Psychiatry. 2010 Mar 1;67(5):439-45. doi: 10.1016/j.biopsych.2009.11.001Hindmarch I. Cognitive toxicity of pharmacotherapeutic agents used in social anxiety disorder. Int J Clin Pract. 2009 Jul;63(7):1085-94. doi: 10.1111/j.1742-1241.2009.02085.xHindmarch I. Cognitive toxicity of pharmacotherapeutic agents used in social anxiety disorder. Int J Clin Pract. 2009 Jul;63(7):1085-94. doi: 10.1111/j.1742-1241.2009.02085.xSowa-Kucma M, Panczyszyn-Trzewik P, Misztak P, et al. Vortioxetine: A review of the pharmacology and clinical profile of the novel antidepressant. Pharmacol Rep. 2017 Aug;69(4):595-601. doi: 10.1016/j.pharep.2017.01.030Sowa-Kucma M, Panczyszyn-Trzewik P, Misztak P, et al. Vortioxetine: A review of the pharmacology and clinical profile of the novel antidepressant. Pharmacol Rep. 2017 Aug;69(4):595-601. doi: 10.1016/j.pharep.2017.01.030Varrone A, Svenningsson P, Marklund P, et al. 5-HT1B receptor imaging and cognition: a positron emission tomography study in control subjects and Parkinson's disease patients. Synapse. 2015 Jul;69(7):365-74. doi: 10.1002/syn.21823Varrone A, Svenningsson P, Marklund P, et al. 5-HT1B receptor imaging and cognition: a positron emission tomography study in control subjects and Parkinson's disease patients. Synapse. 2015 Jul;69(7):365-74. doi: 10.1002/syn.21823Arnsten AF, Lin CH, Van Dyck CH, Stanhope KJ. The effects of 5-HT3 receptor antagonists on cognitive performance in aged monkeys. Neurobiol Aging. 1997 JanFeb;18(1):21-8. doi: 10.1016/s0197-4580(96)00162-5Arnsten AF, Lin CH, Van Dyck CH, Stanhope KJ. The effects of 5-HT3 receptor antagonists on cognitive performance in aged monkeys. Neurobiol Aging. 1997 JanFeb;18(1):21-8. doi: 10.1016/s0197-4580(96)00162-5Meneses A. 5-HT7 receptor stimulation and blockade: a therapeutic paradox about memory formation and amnesia. Front BehavNeurosci. 2014 Jun 12;8:207. doi: 10.3389/fnbeh.2014.00207Meneses A. 5-HT7 receptor stimulation and blockade: a therapeutic paradox about memory formation and amnesia. Front BehavNeurosci. 2014 Jun 12;8:207. doi: 10.3389/fnbeh.2014.00207Fagiolini A, Florea I, Loft H, Christensen MC. Effectiveness of Vortioxetine on Emotional Blunting in Patients with Major Depressive Disorder with inadequate response to SSRI/SNRI treatment. J Affect Disord. 2021 Mar 15;283:472-9. doi: 10.1016/j.jad.2020.11.106Fagiolini A, Florea I, Loft H, Christensen MC. Effectiveness of Vortioxetine on Emotional Blunting in Patients with Major Depressive Disorder with inadequate response to SSRI/SNRI treatment. J Affect Disord. 2021 Mar 15;283:472-9. doi: 10.1016/j.jad.2020.11.106McIntyre RS, Loft H, Christensen MC. Efficacy of Vortioxetine on Anhedonia: Results from a Pooled Analysis of Short-Term Studies in Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat. 2021 Feb 22;17:575-85. doi: 10.2147/NDT.S296451McIntyre RS, Loft H, Christensen MC. Efficacy of Vortioxetine on Anhedonia: Results from a Pooled Analysis of Short-Term Studies in Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat. 2021 Feb 22;17:575-85. doi: 10.2147/NDT.S296451Baune BT, Brignone M, Larsen KG. A Network Meta-Analysis Comparing Effects of Various Antidepressant Classes on the Digit Symbol Substitution Test (DSST) as a Measure of Cognitive Dysfunction in Patients with Major Depressive Disorder. Int J Neuropsychopharmacol. 2018 Feb 1;21(2):97- 107. doi: 10.1093/ijnp/pyx070Baune BT, Brignone M, Larsen KG. A Network Meta-Analysis Comparing Effects of Various Antidepressant Classes on the Digit Symbol Substitution Test (DSST) as a Measure of Cognitive Dysfunction in Patients with Major Depressive Disorder. Int J Neuropsychopharmacol. 2018 Feb 1;21(2):97- 107. doi: 10.1093/ijnp/pyx070

The authors declare that there are no conflicts of interest present.