Vortioxetine for the treatment of depressive episodes associated with Parkinson’s disease: a case series of six patients

Gennaro Barbato 1, Pietro Marano 2, Bruno Passarella 3, Andrea Pilotto 4,5, Giulio Riboldazzi 6, Francesca Spagnolo 3, Paola Vanni 7

1 ASL Napoli 1, Naples, Italy; 2 Casa di Cura Madonna del Rosario, Catania, Italy; 3 UOC Neurologia Ospedale A. Perrino, Brindisi, Italy; 4 Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; 5 Parkinson’s Disease Rehabilitation Centre, FERB ONLUS, S. Isidoro Hospital, Trescore Balneario (BG), Italy; 6 UOS Riabilitazione Parkinson, Fondazione Gaetano e Piera Borghi, Brebbia (VA), Italy; 7 SOS Neurologia, Diagnosi e Cura Disturbi del Movimento, Osp SM Annunziata, AUSL Toscana centro, Florence, Italy

Objectives

We present six case reports of patients with Parkinson’s disease (PD) at various stages, who experienced major depressive episodes that were successfully treated with vortioxetine.

Methods

The patients whose cases are reported in this manuscript were treated in the setting of daily clinical practice.

Results

Of the six cases presented (2 females and 4 males, aged between 56 and 80 years) three had long-standing PD. The remaining three cases were diagnosed with PD at presentation. Most patients had a history of depressive episodes preceding the onset of the motor symptoms typical of PD, or experienced depressive symptoms concomitantly with the onset of the movement disorder. Most patients had therefore been previously exposed to conventional antidepressant medications. Vortioxetine proved consistently effective on depression and related aspects and was generally well tolerated. Symptoms of depression commonly shown by patients with PD, including apathy, cognitive function and sleep disturbances, responded particularly well to vortioxetine.

Conclusions

These observations suggest that vortioxetine has a potential for the management of depressive episodes occurring in the complex and heterogeneous population of patients with PD. Vortioxetine also appears to be well tolerated when taken concomitantly with antiparkinsonian medications. This potential is worth investigating in adequately designed, prospective studies.

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