Cargando…

The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder

Background: Anhedonia is a common, persistent, and disabling phenomenon in treated adults with Major Depressive Disorder (MDD). Hitherto, relatively few antidepressant agents have been evaluated with respect to their effect on anhedonia in MDD. Methods: This is a post-hoc analysis of a primary study...

Descripción completa

Detalles Bibliográficos
Autores principales: Cao, Bing, Park, Caroline, Subramaniapillai, Mehala, Lee, Yena, Iacobucci, Michelle, Mansur, Rodrigo B., Zuckerman, Hannah, Phan, Lee, McIntyre, Roger S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365446/
https://www.ncbi.nlm.nih.gov/pubmed/30766492
http://dx.doi.org/10.3389/fpsyt.2019.00017
_version_ 1783393419085742080
author Cao, Bing
Park, Caroline
Subramaniapillai, Mehala
Lee, Yena
Iacobucci, Michelle
Mansur, Rodrigo B.
Zuckerman, Hannah
Phan, Lee
McIntyre, Roger S.
author_facet Cao, Bing
Park, Caroline
Subramaniapillai, Mehala
Lee, Yena
Iacobucci, Michelle
Mansur, Rodrigo B.
Zuckerman, Hannah
Phan, Lee
McIntyre, Roger S.
author_sort Cao, Bing
collection PubMed
description Background: Anhedonia is a common, persistent, and disabling phenomenon in treated adults with Major Depressive Disorder (MDD). Hitherto, relatively few antidepressant agents have been evaluated with respect to their effect on anhedonia in MDD. Methods: This is a post-hoc analysis of a primary study that sought to evaluate the sensitivity to change of the THINC-integrated tool (THINC-it) in MDD (ClinicalTrials.gov Identifier: NCT03053362). Adults meeting DSM-5 criteria for MDD with at least moderate depressive symptom severity [i.e., Montgomery Åsberg Depression Rating Scale (MADRS) total score ≥20] were eligible. Subjects were recruited between October 2017 and August 2018 in Toronto, Ontario at the Brain and Cognition Discovery Foundation. All subjects received open-label vortioxetine (10–20 mg/day, flexibly-dosed) for 8 weeks. Herein, the primary outcome of interest was the change from baseline to endpoint in the Snaith-Hamilton Pleasure Scale (SHAPS) total score, as well as the MADRS anhedonia factor. The mediational effects of improvements in anhedonia on general function and quality of life, as measured by the Sheehan Disability Scale (SDS) and the 5-Item World Health Organization Well-Being Index (WHO-5), were secondarily assessed. Results: A total of 100 subjects with MDD were enrolled in the primary study and began treatment with vortioxetine. Vortioxetine significantly improved anhedonia as evidenced by significant baseline to endpoint improvements in SHAPS and MADRS anhedonia factor scores (p < 0.0001). Improvements in the SHAPS and the MADRS anhedonia factor correlated with improvements in general function (i.e., SDS) and quality of life (i.e., WHO-5) (p < 0.0001). Notably, improvements in anhedonia were found to mediate the association between improvements in overall depressive symptom severity (i.e., MADRS total score) and social functioning (i.e., social life component of the SDS) (p = 0.026). Conclusion: The unmet need in depression is to improve patient functioning and other patient-reported outcomes (e.g., quality of life). Antidepressant interventions capable of attenuating anhedonia as well as cognitive dysfunction in MDD may help in this regard, as improvement in these domains have been associated with improvement in psychosocial function and quality of life.
format Online
Article
Text
id pubmed-6365446
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-63654462019-02-14 The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder Cao, Bing Park, Caroline Subramaniapillai, Mehala Lee, Yena Iacobucci, Michelle Mansur, Rodrigo B. Zuckerman, Hannah Phan, Lee McIntyre, Roger S. Front Psychiatry Psychiatry Background: Anhedonia is a common, persistent, and disabling phenomenon in treated adults with Major Depressive Disorder (MDD). Hitherto, relatively few antidepressant agents have been evaluated with respect to their effect on anhedonia in MDD. Methods: This is a post-hoc analysis of a primary study that sought to evaluate the sensitivity to change of the THINC-integrated tool (THINC-it) in MDD (ClinicalTrials.gov Identifier: NCT03053362). Adults meeting DSM-5 criteria for MDD with at least moderate depressive symptom severity [i.e., Montgomery Åsberg Depression Rating Scale (MADRS) total score ≥20] were eligible. Subjects were recruited between October 2017 and August 2018 in Toronto, Ontario at the Brain and Cognition Discovery Foundation. All subjects received open-label vortioxetine (10–20 mg/day, flexibly-dosed) for 8 weeks. Herein, the primary outcome of interest was the change from baseline to endpoint in the Snaith-Hamilton Pleasure Scale (SHAPS) total score, as well as the MADRS anhedonia factor. The mediational effects of improvements in anhedonia on general function and quality of life, as measured by the Sheehan Disability Scale (SDS) and the 5-Item World Health Organization Well-Being Index (WHO-5), were secondarily assessed. Results: A total of 100 subjects with MDD were enrolled in the primary study and began treatment with vortioxetine. Vortioxetine significantly improved anhedonia as evidenced by significant baseline to endpoint improvements in SHAPS and MADRS anhedonia factor scores (p < 0.0001). Improvements in the SHAPS and the MADRS anhedonia factor correlated with improvements in general function (i.e., SDS) and quality of life (i.e., WHO-5) (p < 0.0001). Notably, improvements in anhedonia were found to mediate the association between improvements in overall depressive symptom severity (i.e., MADRS total score) and social functioning (i.e., social life component of the SDS) (p = 0.026). Conclusion: The unmet need in depression is to improve patient functioning and other patient-reported outcomes (e.g., quality of life). Antidepressant interventions capable of attenuating anhedonia as well as cognitive dysfunction in MDD may help in this regard, as improvement in these domains have been associated with improvement in psychosocial function and quality of life. Frontiers Media S.A. 2019-01-31 /pmc/articles/PMC6365446/ /pubmed/30766492 http://dx.doi.org/10.3389/fpsyt.2019.00017 Text en Copyright © 2019 Cao, Park, Subramaniapillai, Lee, Iacobucci, Mansur, Zuckerman, Phan and McIntyre. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Cao, Bing
Park, Caroline
Subramaniapillai, Mehala
Lee, Yena
Iacobucci, Michelle
Mansur, Rodrigo B.
Zuckerman, Hannah
Phan, Lee
McIntyre, Roger S.
The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title_full The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title_fullStr The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title_full_unstemmed The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title_short The Efficacy of Vortioxetine on Anhedonia in Patients With Major Depressive Disorder
title_sort efficacy of vortioxetine on anhedonia in patients with major depressive disorder
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365446/
https://www.ncbi.nlm.nih.gov/pubmed/30766492
http://dx.doi.org/10.3389/fpsyt.2019.00017
work_keys_str_mv AT caobing theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT parkcaroline theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT subramaniapillaimehala theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT leeyena theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT iacobuccimichelle theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT mansurrodrigob theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT zuckermanhannah theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT phanlee theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT mcintyrerogers theefficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT caobing efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT parkcaroline efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT subramaniapillaimehala efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT leeyena efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT iacobuccimichelle efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT mansurrodrigob efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT zuckermanhannah efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT phanlee efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder
AT mcintyrerogers efficacyofvortioxetineonanhedoniainpatientswithmajordepressivedisorder