Vortioxetine on Cognition in Schizophrenia: A Pilot Study. Issue 4 (July 2020)

• Record Type: Journal Article
• Authors: Bruno, Antonio; Zoccali, Rocco Antonio; Troili, Giulia Maria; Scala, Loredana; Pandolfo, Gianluca; Cedro, Clemente; Mento, Carmela; Santoro, Vincenza; Spina, Edoardo; Muscatello, Maria Rosaria Anna
• Is Part Of: Journal of clinical psychopharmacology. Volume 40:Issue 4(2020)
• Publication Date: 2020-07
• Subjects: cognition -- executive functions -- schizophrenia -- vortioxetine; Psychopharmacology -- Periodicals; Psychopharmacology -- Periodicals; Psychopharmacologie -- Périodiques; Psychopharmacology; Periodicals; 615.78
• DOI: 10.1097/JCP.0000000000001242
• Languages: English
• ISSNs: 0271-0749

Abstract

Abstract : Background: Given the wide implications of cognitive impairment for prognosis and outcome in schizophrenia, the research on pharmacological approaches aimed at addressing dysfunctional cognition has been extensive; nevertheless, there are no currently available licensed drugs, and the evidence in this field is still unimpressive. Vortioxetine is a multimodal antidepressant, which has been proposed as a suitable treatment option for cognitive symptoms in depression. Methods: Twenty schizophrenia outpatients (mean age ± SD, 40.7 ±10.6 years) on stable clozapine treatment, assessed by neuropsychological (Wisconsin Card Sorting Test, Verbal Fluency, and Stroop task) and psychodiagnostic instruments (Positive and Negative Syndrome Scale [PANSS] and Calgary Depression Scale for Schizophrenia), received vortioxetine at the single daily dose of 10 mg/d until week 12; the dose was increased at 20 mg/d afterward, and this dosage was maintained unchanged until week 24. A physical examination, electrocardiogram with QTc measurement, and laboratory tests were also performed. Results: Vortioxetine supplementation significantly improved Stroop test ( P = 0.013) at week 12 and Stroop test ( P = 0.031) and Semantic Fluency ( P = 0.002) at end point. Moreover, a significantly reduction of PANSS domains "positive" ( P = 0.019) at week 12 and of PANSS domains positive ( P = 0.019) and total score ( P = 0.041) and of depressive symptoms (Calgary Depression Scale for Schizophrenia, P = 0.032) at end point. There was no significant change in clinical, metabolic, and safety parameters, and no subject spontaneously reported adverse effects. Conclusions: Despite the limitations (open design, lack of a control group, small sample size, and short intervention period), our findings suggest for the first time that vortioxetine augmentation of clozapine may be a promising therapeutic strategy for addressing cognitive deficits in patients with schizophrenia.