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Vortioxetine offers potential benefit as adjunctive to antipsychotics in chronic schizophrenia

Key clinical point: Vortioxetine as an adjunctive to antipsychotics improves negative symptoms and overall symptoms in patients with schizophrenia.

Major finding: Compared with the placebo group, the vortioxetine group had a significant improvement in Positive and Negative Syndrome Scale (PANSS) negative symptoms (mean difference [MD], −1.82; 95% CI, −2.73 to −0.92) and total PANSS (MD, −2.09; 95% CI, −3.16 to −1.01; P less than .001 for both) scores from baseline to endpoint at 8 weeks, accompanied by significant time × treatment interactions and effect sizes.

Study details: Randomized controlled trial included 78 patients with chronic schizophrenia who were stabilized with risperidone (4-6 mg/day) before being assigned to receive either adjunctive vortioxetine (10 mg twice-daily) or placebo. All patients were evaluated for PANSS negative symptoms and total PANSS scores.

Disclosures: This study was supported by a grant to Prof. Shahin Akhondzadeh from the Tehran University of Medical Sciences (TUMS). The authors declared no conflicts of interest.

Commentary

"Many individuals with schizophrenia continue to have sub-optimal health outcomes in spite of treatment with evidence-based antipsychotic drugs. Residual negative symptoms in particular are associated with long-term functional deficits. For patients with schizophrenia who are on stable antipsychotic treatment, the broader literature suggests that adjunctive antidepressants may be effective for total and particularly negative symptom reduction in some patients. While the overall literature suggests that improvement might be incremental and relatively modest, even a slight reduction in negative symptoms could potentially translate to improvement in quality of life and interpersonal relationships. This report adds to the existing literature on possible negative-symptom augmentation treatment strategies that clinicians can consider with currently available therapeutic agents."

Martha Sajatovic, MD
Professor of Psychiatry and of Neurology
Willard Brown Chair in Neurological Outcomes Research
Director, Neurological and Behavioral Outcomes Center, University Hospitals
Cleveland Medical Center
Case Western Reserve University School of Medicine

Dr. Sajatovic has no relevant financial conflicts of interest.
Citation:

Mozen-Zadeh E et al. J Psychopharmacol. 2020 Mar 2. doi: 10.1177/0269881120909416.