Cargando…

Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series

Epilepsy and depression are both serious and potentially disabling conditions which often coexist—bidirectional relationship between the two disorders has been observed. Comorbidity between depression and epilepsy can be attributed to: underlying common pathophysiological mechanisms, psychiatric sid...

Descripción completa

Detalles Bibliográficos
Autores principales: Siwek, Marcin, Gorostowicz, Aleksandra, Bosak, Magdalena, Dudek, Dominika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009204/
https://www.ncbi.nlm.nih.gov/pubmed/35431973
http://dx.doi.org/10.3389/fphar.2022.852042
_version_ 1784687222278062080
author Siwek, Marcin
Gorostowicz, Aleksandra
Bosak, Magdalena
Dudek, Dominika
author_facet Siwek, Marcin
Gorostowicz, Aleksandra
Bosak, Magdalena
Dudek, Dominika
author_sort Siwek, Marcin
collection PubMed
description Epilepsy and depression are both serious and potentially disabling conditions which often coexist—bidirectional relationship between the two disorders has been observed. Comorbidity between depression and epilepsy can be attributed to: underlying common pathophysiological mechanisms, psychiatric side effect of antiepileptic medications and psychological response to stress in people with chronic, neurological condition. Despite high prevalence of depressive symptoms in patients with epilepsy, current evidence of the effectiveness of antidepressant therapy in this group of patients is very limited. Vortioxetine is an antidepressant with multimodal activity, very good treatment tolerability, low risk of inducing pharmacokinetic interactions, relative safety of treatment in patients with somatic comorbidities, low risk of causing: sedation, sexual dysfunctions and metabolic side effects. Vortioxetine seems to be a promising treatment option for depressed patients with cognitive dysfunctions, anhedonia and anxiety. In this case series, we report nine cases of patients with epilepsy and depressive symptoms treated with vortioxetine. Seven cases are patients with secondary focal and generalized epilepsy and two with unclassified epilepsy. Three patients presented with depressive episode in the course of bipolar disorder and six patients had depressive symptoms due to organic mood disorder. The dose range of vortioxetine was between 10 and 20 mg. In all of the presented cases effectiveness and tolerability of treatment were very good. Remission of depressive symptoms was achieved in all patients. No epilepsy seizures after switch to vortioxetine were observed in seven cases. In two patients seizures occurred during the first months of vortioxetine treatment but this most probably was due to suboptimal antiepileptic treatment—satisfactory seizure control was achieved after optimization of antiepileptic pharmacotherapy. Vortioxetine was discontinued in two of the presented cases due to pregnancy planning. The duration of observation period during vortioxetine therapy ranged from 2 to 48 months. In conclusion, vortioxetine can be a promising treatment option in patients with epilepsy and comorbid depressive symptoms.
format Online
Article
Text
id pubmed-9009204
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-90092042022-04-15 Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series Siwek, Marcin Gorostowicz, Aleksandra Bosak, Magdalena Dudek, Dominika Front Pharmacol Pharmacology Epilepsy and depression are both serious and potentially disabling conditions which often coexist—bidirectional relationship between the two disorders has been observed. Comorbidity between depression and epilepsy can be attributed to: underlying common pathophysiological mechanisms, psychiatric side effect of antiepileptic medications and psychological response to stress in people with chronic, neurological condition. Despite high prevalence of depressive symptoms in patients with epilepsy, current evidence of the effectiveness of antidepressant therapy in this group of patients is very limited. Vortioxetine is an antidepressant with multimodal activity, very good treatment tolerability, low risk of inducing pharmacokinetic interactions, relative safety of treatment in patients with somatic comorbidities, low risk of causing: sedation, sexual dysfunctions and metabolic side effects. Vortioxetine seems to be a promising treatment option for depressed patients with cognitive dysfunctions, anhedonia and anxiety. In this case series, we report nine cases of patients with epilepsy and depressive symptoms treated with vortioxetine. Seven cases are patients with secondary focal and generalized epilepsy and two with unclassified epilepsy. Three patients presented with depressive episode in the course of bipolar disorder and six patients had depressive symptoms due to organic mood disorder. The dose range of vortioxetine was between 10 and 20 mg. In all of the presented cases effectiveness and tolerability of treatment were very good. Remission of depressive symptoms was achieved in all patients. No epilepsy seizures after switch to vortioxetine were observed in seven cases. In two patients seizures occurred during the first months of vortioxetine treatment but this most probably was due to suboptimal antiepileptic treatment—satisfactory seizure control was achieved after optimization of antiepileptic pharmacotherapy. Vortioxetine was discontinued in two of the presented cases due to pregnancy planning. The duration of observation period during vortioxetine therapy ranged from 2 to 48 months. In conclusion, vortioxetine can be a promising treatment option in patients with epilepsy and comorbid depressive symptoms. Frontiers Media S.A. 2022-03-31 /pmc/articles/PMC9009204/ /pubmed/35431973 http://dx.doi.org/10.3389/fphar.2022.852042 Text en Copyright © 2022 Siwek, Gorostowicz, Bosak and Dudek. https://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 Pharmacology
Siwek, Marcin
Gorostowicz, Aleksandra
Bosak, Magdalena
Dudek, Dominika
Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title_full Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title_fullStr Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title_full_unstemmed Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title_short Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series
title_sort case report: vortioxetine in the treatment of depressive symptoms in patients with epilepsy—case series
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009204/
https://www.ncbi.nlm.nih.gov/pubmed/35431973
http://dx.doi.org/10.3389/fphar.2022.852042
work_keys_str_mv AT siwekmarcin casereportvortioxetineinthetreatmentofdepressivesymptomsinpatientswithepilepsycaseseries
AT gorostowiczaleksandra casereportvortioxetineinthetreatmentofdepressivesymptomsinpatientswithepilepsycaseseries
AT bosakmagdalena casereportvortioxetineinthetreatmentofdepressivesymptomsinpatientswithepilepsycaseseries
AT dudekdominika casereportvortioxetineinthetreatmentofdepressivesymptomsinpatientswithepilepsycaseseries