Vortioxetine for Cognitive Impairment in Major Depressive Disorder During Post-COVID Syndrome: Real-World Evidence.

Objective

To compare the effectiveness of vortioxetine versus escitalopram and sertraline as a treatment in individuals with major depressive disorder (MDD) and post-COVID syndrome (PCS).

Methods

This is a prospective, open-label, comparative effectiveness study in individuals with new-onset MDD as PCS outcome. The study was carried out in 1 clinical site. Individuals who had a history of confirmed SARS-CoV 2 infection, who met World Health Organization-defined criteria for PCS, and who met new-onset of MDD criteria according to DSM-5-TR were included. Participants that were eligible were assigned to receive vortioxetine at 10-20 mg/d, escitalopram 10-20 mg/d, or sertraline 50-200 mg/d over 8 weeks. The primary and secondary outcomes were changes from baseline to end point in Digital Symbol Substitution Test (DSST) and Montgomery-Asberg Depression Rating Scale (MADRS) or Patient Reported Outcome Measurement Information System Fatigue Short Form 7a (PROMIS 7a), respectively. Data were collected during January 2022 and December 2023.

Results

140 participants were assigned to received vortioxetine (n = 70), escitalopram (n = 36), or sertraline (n = 34). Participants assigned to vortioxetine exhibited significant changes in DSST scores from baseline to end point compared to escitalopram or sertraline (least squares [LS] mean differences, 8.25; 95% CI, 6.25-10.25; P < .001; LS mean differences, 8.00; 95% CI, 5.95-10.06; P < .001, respectively). Participants in the vortioxetine treatment group reported significantly greater changes in total MADRS scores from baseline to end point compared to escitalopram or sertraline (LS mean differences, -4.06; 95% CI, -4.92 to -3.20; P < .001; LS mean differences, -3.94; 95% CI, -4.83 to -3.06; P < .001, respectively).

Conclusion

Vortioxetine has a significant procognitive effect. Antidepressant effects and improvement in fatigue symptoms (PROMIS 7a) also were observed.