Assessing Clinical Outcomes in Major Depressive Disorder
About
A portion of patients treated with antidepressants continue to face challenges in responding to treatment or achieving remission. Furthermore, residual symptoms and side effects common with antidepressant therapies present barriers to achieving treatment goals. These challenges can also have major economic and quality of life impacts. This retrospective chart review of Parkview patient medical records evaluated the care experiences of major depressive disorder (MDD) patients and the effectiveness of vortioxetine use on patient outcomes. Data from this study was used to examine the extent to which the prescription of vortioxetine is beneficial to patients in terms of care experience, mental health, and quality of life outcomes.
Methods
This retrospective chart review evaluated the short-term (12-week) effectiveness of vortioxetine in 1,242 patients (mean, 45.93 years; 91% Caucasian ; 63.9% with ≥3 comorbid psychiatric conditions) from Parkview Physicians Group – Mind-Body Medicine. Inclusion criteria: aged ≥18 years with at least one diagnosis of MDD, a prescription for vortioxetine, an initial visit and at least two follow-up visits (from September 1, 2014, to December 31, 2018). Primary outcome measure: effectiveness of vortioxetine on depression severity (assessed by change from baseline in Patient Health Questionnaire [PHQ]-9 score) at 12 weeks. Secondary outcomes: changes in anxiety symptoms (GAD-7), cognitive symptoms (PDQ-20), sexual dysfunction and sleep disturbance (PRISE, clinical narrative notes). Other secondary outcomes: response (≥50% reduction in PHQ-9), remission (PHQ-9 ≤4), and persistence rates (percent of patients who continued using vortioxetine) at 12 weeks.
Results
Significant improvements were noted in PHQ-9, GAD-7, and PDQ-20 scores as well as in sleep disturbance and sexual dysfunction. Response rate was 31.0%; remission rate, 23.1%; and persistence rate, 66.9% by 12 weeks.
Conclusions
In a real-world setting, vortioxetine was effective in significantly reducing depression severity and improving anxiety, sexual dysfunction, sleep, and perception of cognitive dysfunction in patients with MDD. At 12 weeks, about 1 in 3 patients showed clinical response, 1 in 5 were in remission, and two-thirds continued vortioxetine.
Limitations
Lack of a control group; sample not diverse (91% Caucasian); only examining 12 weeks after medication initiated.
Partners
Funding
- Takeda Pharmaceuticals CW2693521
Publications and presentations
- McDaniel, B.T., Cornet, V., McCue, M., Patel, S., & Fawver, J. (2021, May 1-3). Treatment Patterns and Outcomes in Patients with Major Depressive Disorder Treated with Vortioxetine in a Real-World Setting [Poster session]. American Psychiatric Association Annual Meeting (Virtual)
- McDaniel, B. T., Cornet, V., Carroll, J., Chrones, L., Chudzik, J., Cochran, J., Guha, S., Lawrence, D.F., McCue, M., Skarkey, S., Lorenz, B. & Fawver, J. (2023). Real-world clinical outcomes and treatment patterns in patients with MDD treated with vortioxetine: a retrospective study. BMC psychiatry, 23(1), 1-14. https://doi.org/10.1186/s12888-023-05439-8
Press
All projects