Antidepressant therapies have traditionally been evaluated for their effect on symptoms of depression and anxiety. However, symptomatic improvements may not result in functional gains in areas such as work performance and productivity, activities of daily living and quality of life. In the latest iteration of the Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder (MDD), functional recovery was recognized as a priority in the treatment of MDD in both the acute and maintenance phases of the disease (Lam et al. Ann Clin Psychiatry 2015;27:142-149). The group concluded that there was a need for evidence-based interventions that demonstrated an improvement in patient functioning.
Two new studies have examined the effect of vortioxetine (Trintellix) on functional outcomes, and the interrelationship of work productivity and cognition. Vortioxetine is a multimodal serotonergic agent that inhibits the 5-hydroxytryptamine (HT) transporter, is an agonist of the 5-HT1A receptor, a partial agonist of the 5-HT1B receptor, and is an antagonist of the 5-HT1D, 5-HT3 and 5-HT7 receptors (Bang-Andersen et al. J Med Chem 2011;54:3206-3221). The CANMAT guidelines on pharmacological treatment recommend vortioxetine as a first-line therapy for MDD (Kennedy et al. Can J Psychiatry 2016;61:540-560).