The use of vortioxetine for depression in patients with Parkinson's disease in the early and advanced stages of the disease
https://doi.org/10.14412/2074-2711-2020-5-40-45
Abstract
Depression is one of the most common non-motor manifestations of Parkinson's disease (PD), which largely determines both the severity of the course of the disease and the life expectancy of patients, as well as the compliance of patients to and the efficiency of antiparkinsonian therapy. In this connection, the search for a safe and effective antidepressant for patients with PD is of particular relevance.
Objective: to evaluate the efficacy and safety of vortioxetine in patients with PD complicated by mild to moderate depression.
Patients and methods. Examinations were made in 150 patients with PD in its early and advanced stages (Hoehn-Yahr stages: 1.0 to 3.0). All the patients were treated with vortioxetine at a dose of 15 or 20 mg/day for 8 months. The investigators used clinical and psychopathological rating scales, such as the Hospital Depression Scale (HADS-D), the Hospital Anxiety Scale (HADS-A), the Beck Depression Inventory (BDI), and the Montgomery-Asberg Depression Rating Scale (MADRS). The severity of PD motor manifestations was assessed according to the Unified PD Rating Scale (UPDRS) Part III.
Results and discussion. During the follow-up period corresponding to 12 weeks of vortioxetine use, all the patients showed a significant decrease in MARDS, HADS-A and HADS-D, and BDI scores for depression and anxiety (p < 0.001). Vortioxetine demonstrated an optimal balance between tolerability and clinical efficacy in correcting affective disorders in this patient group. In addition, analysis of the dynamics of motor disorders yielded data on the improvement of movement functions while correcting depression as lower UPDRS Part III total scores (p < 0.001).
Conclusion. The findings suggest that vortioxetine has a significant effect on depression and anxiety in patients with PD in its early and advanced stages, good tolerability, and a rapid-onset effect.
About the Author
I. V. MiliukhinaRussian Federation
Irina V. Miliukhina
12, Academician Pavlov St., Saint Petersburg 197376,
6/8, Lev Tolstoy St., Saint Petersburg 197022
References
1. Milyukhina IV. Pathogenesis, clinical features, and treatments of depression in Parkinson's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(2):93-9. doi: 10.14412/2074-2711-2019-2-93-99 (In Russ.).
2. Zhuo C, Xue R, Luo L, et al. Efficacy of antidepressive medication for depression in Parkinson disease. Medicine (Baltimore). 2017 Jun;96(22):e6698. doi: 10.1097/MD.0000000000006698
3. Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018 Apr 7;391(10128):1357-66. doi: 10.1016/S0140-6736(17)32802-7. Epub 2018 Feb 21.
4. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/mds.26424
5. Schrag A, Barone P, Brown RG, et al. Depression rating scales in Parkinson's disease: critique and recommendations. Mov Disord. 2007 Jun 15;22(8):1077-92. doi: 10.1002/mds.21333
6. Dissanayaka NN, Sellbach A, Silburn PA, et al. Factors associated with depression in Parkinson's disease. J Affect Disord. 2011 Jul;132(1-2):82-8. doi: 10.1016/j.jad.2011.01.021. Epub 2011 Feb 26.
7. Georgiev D, Hamberg K, Hariz M, et al. Gender differences in Parkinson's disease: A clinical perspective. Acta Neurol Scand. 2017 Dec;136(6):570-84. doi: 10.1111/ane.12796. Epub 2017 Jul 2.
8. Gauthier C, Souaiby L, Advenier-Iakovlev E, Gaillard R. Pramipexole and Electroconvulsive Therapy in TreatmentResistant Depression. Clin Neuropharmacol. Nov/Dec 2017;40(6):264-7. doi: 10.1097/WNF.0000000000000253
9. Moirand R, Galvao F, Donde C. Pramipexole and Selegiline Combination Therapy in a Case of Treatment-Resistant Depression. J Clin Psychopharmacol. Nov/Dec 2019;39(6):684-5. doi: 10.1097/JCP.0000000000001139
10. Bomasang-Layno E, Fadlon I, Murray AN, et al. Antidepressive treatments for Parkinson's disease: A systematic review and meta-analysis. Parkinsonism Relat Disord. 2015 Aug;21(8):833- 42; discussion 833. doi: 10.1016/j.parkreldis.2015.04.018. Epub 2015 May 16.
11. Cooney JW, Stacy M. Neuropsychiatric issues in Parkinson's disease. Curr Neurol Neurosci Rep. 2016 May;16(5):49. doi: 10.1007/s11910-016-0647-4
12. Zahodne LB, Bernal-Pacheco O, Bowers D, et al. Are selective serotonin reuptake inhibitors associated with greater apathy in Parkinson's disease? J Neuropsychiatry Clin Neurosci. Summer 2012;24(3):326-30. doi: 10.1176/appi.neuropsych.11090210
13. Nodel of MR, Yakhno NN. Apathy at Parkinson's illness. Nevrologicheskii zhurnal. 2014;(1):9-15 (In Russ.).
14. Mills KA, Greene MC, Dezube R, et al. Efficacy and tolerability of antidepressants in Parkinson's disease: A systematic review and network meta-analysis. Int J Geriatr Psychiatry. 2018 Apr;33(4):642-51. doi: 10.1002/gps.4834. Epub 2017 Dec 13.
15. Shagiakhmetov FSh, Anokhin PK, Shamakina IYu. Vortioxetine: mechanisms of multimodality and clinical efficacy. Sotsial'naya i klinicheskaya psikhiatriya. 2016;26(4):84-96 (In Russ.).
16. Pehrson AL, Cremers T, Betry C, et al. Lu AA21004, a novel multimodal antidepressant, produces regionally selective increases of multiple neurotransmitters – a rat microdialysis and electrophysiology study. Eur Neuropsychopharmacol. 2013;23(2):133-45. doi: 10.1016/j.euroneuro.2012.04.006. Epub 2012 May 20.
17. Chen G, Hojer A-M, Areberg J, Nomikos G. Vortioxetine: Clinical Pharmacokinetics and Drug Interactions. Clin Pharmacokinet. 2018 Jun;57(6):673-86. doi: 10.1007/s40262-017-0612-7
18. Yee A, Ng CG, Seng LH. Vortioxetine Treatment for Anxiety Disorder: A Meta-Analysis Study. Curr Drug Targets. 2018;19(12):1412-23. doi: 10.2174/1389450118666171117131151
19. Milyukhina IV, Karpenko MN, Klimenko VM. Clinical parameters and the level of certain cytokines in blood and cerebrospinal fluid of patients with parkinson's disease. Klinicheskaya meditsina. 2015;93(1):51-6 (In Russ.).
20. Miller AH, Raison CL. The role of inflammation in depression: From evolutionary imperative to modern treatment target. Nat Rev Immunol. 2016 Jan;16(1):22-34. doi: 10.1038/nri.2015.5
21. De Sousa Tomaz V, Filho AJMC, Cordeiro RC et al. Antidepressants of different classes cause distinct behavioral and brain proand anti-inflammatory changes in mice submitted to an inflammatory model of depression. J Affect Disord. 2020 May 1;268:188-200. doi: 10.1016/j.jad.2020.03.022. Epub 2020 Mar 6.
22. Chaudhuri KR, Healy DJ, Schapira AHV. Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurol. doi: 10.1016/S1474-4422(06)70373-8
23. Errea JM, Ara JR. Depression and Parkinson disease. Rev Neurol. 1999 Apr 1- 15;28(7):694-8. doi: 10.33588/rn.2807.98173
24. Christensen MC, Florea I, Lindsten A, Baldwin DS. Efficacy of vortioxetine on the physical symptoms of major depressive disorder. J Psychopharmacol. 2018 Oct;32(10):1086-97. doi: 10.1177/0269881118788826. Epub 2018 Jul 26.
25. Lee Y, Oh JS, Chung SJ, et al. The presence of depression in de novo Parkinson's disease reflects poor motor compensation. PLoS One. 2018 Sep 19;13(9):e0203303. doi: 10.1371/journal.pone.0203303. eCollection 2018.2
Review
For citations:
Miliukhina IV. The use of vortioxetine for depression in patients with Parkinson's disease in the early and advanced stages of the disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(5):40-45. (In Russ.) https://doi.org/10.14412/2074-2711-2020-5-40-45