Psychiatria pre prax S3/2022

Functional recovery as an achievable goal of the treatment of depression

Depression is one of the most common psychiatric disorders. It covers a variety of symptoms in emotional, cognitive, somatic, and behavioural dimensions, including depressed mood, diminished interests and/or pleasure, cognitive problems, indecisiveness, guilty and hopelessness feelings, suicidal thoughts, anxiety, pain or psychosomatic complaints, fatigue, psychomotor inhibition and changes in appetite and sleep patterns, with a significant psychosocial impact. Impaired cognitive function is one of the most common residual symptoms of depression. Depression is a heterogeneous psychiatric syndrome associated with a substantial all-society burden; however, a considerable part of the burden corresponds to unsuccessful treatments. This possibly results from the complex and multifactorial aetiology of depression involving biological, psychosocial, environmental, and genetic factors. This could explain why most patients fail to respond to standard antidepressants. Vortioxetine as a multimodal antidepressant was placed in the category of “other” antidepressants and may therefore provide an alternative to existing antidepressant drugs, and thanks to the unique mechanism of action, it can be used as a first-line option. Vortioxetine has been found to be one of the most effective and best-tolerated options for depression in head-to-head trials. Vortioxetine 20 mg is significantly more effective than the 10 mg dose in patients with depression, with a similar tolerability profile. Vortioxetine is the first antidepressant drug with proven efficacy in improving cognitive symptoms of depression and has shown to be very effective in symptoms of anhedonia with low rates of sexual dysfunction.

Keywords: depression, heterogeneity, functional recovery, cognitive symptoms, anhedonia, vortioxetine