A 54-year-old man with major depression (MD) was admitted to hospital. He had previously experienced two episodes of MD and was currently experiencing the third one. He exhibited a depressed mood, restlessness, agitation, insomnia, and worthlessness, and he also feared that his gaze always made others uncomfortable. He could not look colleagues in the eye at his workplace and avoided meeting or talking to them. A diagnosis of comorbid social phobia with MD was established and treatment with fluvoxamine (maximum dose: 150 mg/day), sertraline (maximum dose: 100 mg/day), or escitalopram (maximum dose: 20 mg/day) plus alprazolam (maximum dose: 0.8 mg/day) was initiated. However, his problems were only partially alleviated. Therefore, vortioxetine was initiated at 10 mg/day and increased to 20 mg/day. Four weeks after initiation of vortioxetine, his depressed mood, restlessness, and agitation were ameliorated, although his social phobia persisted and he continued to take alprazolam (0.8 mg/day). Eight weeks later, his fears concerning his gaze and his anxiety gradually diminished, and he did not require alprazolam on a regular basis. He continued to take vortioxetine (20 mg/day) alone and gradually resumed a normal life without the inconvenience.
Results
c) Vortioxetine
Vortioxetine is a multimodal-acting antidepressant that provides improvements in cognitive function
Vortioxetine is the first antidepressant that has shown improvements both in depression and cognitive symptoms, due to the unique multimodal mechanism of action that combines the 5-HT reuptake inhibition with modulations of other key pre- and post-synaptic 5-HT receptors Vortioxetine has been found to be one of the most effective and best-tolerated options for major depressive disorder (MDD) in head-to-head trials.