Effectiveness and Tolerability of Vortioxetine Oral Drops Versus Oral Tablets in Major Depressive Disorder: An Analysis of a Real-World Cohort Study in Switzerland.

Abstract

Background: The efficacy and tolerability of vortioxetine tablets for depression is established, but prospective data for the oral drop formulation were unavailable. This analysis compared the effectiveness, tolerability and dosing patterns of vortioxetine tablet and drop formulations for the treatment of major depressive episodes in Swiss real-world practice.

Methods: A post hoc analysis of a prospective, non-interventional study in adults experiencing a major depressive episode (MDE) was conducted. Depression symptoms, functioning, dosing patterns and tolerability were assessed using unanchored Montgomery-Åsberg Depression Rating Scale items, the Clinical Global Impression-Severity (CGI-S) scale, a four-point functioning scale, and incidence of adverse drug reactions (ADRs). Statistical tests included two-sample t-tests, Fisher's exact test, Chi-square test and general linear modelling.

Results: Of 225 patients, 60 (26.7%) initiated drops. Drops were more often prescribed for first MDE than tablets (65.0% [n = 39] versus 46.1% [n = 76]; p = 0.012) and shorter MDE duration at baseline (2.9 versus 4.8 months; p = 0.02). Mean CGI-S baseline scores were similar (drops: 5.0; tablets: 4.8). Both formulations improved depressive symptoms and functioning similarly. Drops were used in lower initial doses (4.2 mg/day) versus tablets (7.7 mg/day) (p < 0.001) but in higher doses (> 10 mg/day) earlier during treatment (35% versus 13%, day 15). 'No or little effect' was significantly less frequent with drops (5.0%; n = 3) versus tablets (23.6%; n = 39) (p < 0.001). ADR-related discontinuations were comparable (drops: 3.3%; tablets: 4.2%).

Conclusions: This real-world analysis suggests that vortioxetine drops provide comparable control of depressive symptoms to tablets. The greater capacity for dose individualisation may be beneficial to patients.