Vortioxetine and Cognition in Older Adults: A Mini Review

Abstract

Aging is associated with progressive cognitive decline affecting the quality of life. Cognitive impairment may present as a symptom in various physical and psychiatric illnesses, complicating the course of the illness. Late-life depression is commonly linked to cognitive impairment and has a role in treatment response. The novel antidepressant vortioxetine acts primarily by inhibiting the serotonin transporters, 5HT3, 5HT7 and 5HT1D receptor antagonists, 5HT1A, 5HT1B receptor agonists and partial agonists, respectively. The multimodal action is responsible for its antidepressant and pro-cognitive effect. The pro-cognitive effect of vortioxetine is highlighted in few systematic reviews in comparison to other antidepressants. The published literature included studies with subjects belonging to the adult age group. Till date, one systematic review demonstrated the cognitive effect of vortioxetine in the elderly, which included three studies with a diverse study population. A total of five studies encompassing the pro-cognitive effect of vortioxetine in normal aging, late-life depression, mild cognitive impairment and Alzheimer’s disease with depressive symptoms are included in the current review. A total of four studies replicated the pro-cognitive effect of vortioxetine in different dose ranges in a diverse study population in the elderly age group. One of the studies demonstrates no effect of vortioxetine on cognition in the elderly. The review directs focus to the areas needed to be further studied. Study of the long-term effect of vortioxetine on cognition, dose-response relationship, uniform study population and replication of previous study findings are needed in future context.