Wortioksetyna – lek przeciwdepresyjny o wielofunkcyjnym mechanizmie działania

• Authors: Adam Wysokiński , Tomasz Sobów

Title variants

EN

Vortioxetine – an antidepressant with a multifunctional mechanism of action

• Languages of publication: EN PL

Abstracts

EN

Depression is one of the most invalidating chronic diseases, and the efficacy of the available antidepressants is limited. Remission is observed in only a third of cases of depressive patients following the use of the first drug. Also a third of patients are drug-resistant which means they do not improve despite the administration of multiple drugs. More and more attention is paid to cognitive dysfunctions (such as attention and memory disorders, executive function disorders, slow information processing) which are one of the key symptoms in the course of depression. These are characterised by a high incidence in depressive patients (up to 94% of all patients affected by the episode of depression and up to 44% of patients in remission) and largely affect their quality of life. Vortioxetine is a new antidepressant, with so-called multifunctional mechanism of action, comprising the inhibition of the serotonin transporter, partial agonism of the 5-HT1A and 5-HT1B receptors, and antagonism of the 5-HT3A and 5-HT7 receptors. Vortioxetine has a well-documented anti-depression efficacy both in short- and long-term therapy. Most available data point to the efficacy of the said antidepressant when administered in the daily dose of 10 mg and more, yet the 10 mg dose has a similar efficacy to 15 or 20 mg. Adverse event profile of vortioxetine may be better than for other antidepressants (mainly for duloxetine and venlafaxine). Beneficial effect of vortioxetine on cognitive impairment which may be independent of its antidepressant action is clinically important and interesting. Moreover, in comparison to other antidepressants, vortioxetine has a good tolerability profile in terms of sexual dysfunction and does not significantly affect the body mass and other metabolic parameters.

PL

Depresja pozostaje jedną z najbardziej inwalidyzujących chorób przewlekłych, a skuteczność dostępnych leków przeciwdepresyjnych jest ograniczona. Jedynie około ⅓ pacjentów uzyskuje remisję po zastosowaniu pierwszego leku; również około ⅓ chorych cechuje się lekoopornością, czyli nie uzyskuje poprawy mimo zastosowania różnych leków. Coraz większą uwagę zwraca się na dysfunkcje poznawcze (zaburzenia uwagi, pamięci i funkcji wykonawczych, wolniejsze tempo przetwarzania informacji), należące do kluczowych objawów w przebiegu depresji. Są one częste u pacjentów z depresją (do 94% wszystkich chorych w trakcie epizodu depresji oraz do 44% osób w fazie remisji) i znacząco wpływają na jakość życia. Wortioksetyna jest nowym lekiem przeciwdepresyjnym o wielofunkcyjnym mechanizmie działania, który obejmuje hamowanie transportera serotoniny, częściowy agonizm wobec receptorów 5-HT1A i 5-HT1B oraz antagonizm wobec receptorów 5-HT3A i 5-HT7. Wortioksetyna ma dobrze udokumentowaną skuteczność przeciwdepresyjną – w leczeniu zarówno krótko-, jak i długoterminowym. Najwięcej danych wskazuje na skuteczność leku stosowanego w dawce dobowej 10 mg i wyższej, przy czym dawka 10 mg ma podobną skuteczność jak 15 i 20 mg. Profil działań ubocznych wortioksetyny może być lepszy niż w przypadku innych leków przeciwdepresyjnych (głównie duloksetyny i wenlafaksyny). Uwagę zwraca korzystny wpływ wortioksetyny na zaburzenia poznawcze, który może być niezależny od jej działania przeciwdepresyjnego. Ponadto w porównaniu z innymi lekami przeciwdepresyjnymi wortioksetyna cechuje się dobrym profilem tolerancji w zakresie dysfunkcji seksualnych oraz nie wpływa istotnie na masę ciała i inne parametry metaboliczne.

Keywords

EN

cognitive dysfunctions   depresja   depression   dysfunkcje poznawcze   vortioxetine   wortioksetyna  

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Psychiatria i Psychologia Kliniczna
• Year: 2016
• Volume: 16
• Issue: 2
• Pages: 99–103

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• Document Type: review