Dubovsky Steven L
University at Buffalo, Department of Psychiatry , 462 Grider St Room 1182, Buffalo, NY 14215 , USA +1 716 898 5940 ;
Expert Opin Drug Metab Toxicol. 2014 May;10(5):759-66. doi: 10.1517/17425255.2014.904286. Epub 2014 Apr 1.
Major depressive disorder (MDD), one of the most common disorders in medical practice and one of the leading causes of disability worldwide, is frequently comorbid with anxiety disorders. Vortioxetine (Lu AA21004) is a new antidepressant that combines a number of neurotransmitter reuptake and receptor effects that have been thought to predict efficacy as a treatment for depressive and anxiety disorders.
This review summarizes the pharmacology and neurobiology of vortioxetine. Studies of its efficacy and tolerability in major depression and generalized anxiety disorder are critically reviewed.
Despite the fact that industry-sponsored studies are more likely than other clinical trials to support efficacy of the experimental drug, results have been mixed. Some studies supported that vortioxetine is superior to placebo in the treatment of MDD and some do not. Two studies supported the efficacy of vortioxetine in the treatment of generalized anxiety disorder and two do not. The incidence of sexual dysfunction has varied considerably in different studies, but cardiac effects and psychomotor impairment seem to be minimal. Advantages of vortioxetine over existing antidepressants are not yet clear.
重度抑郁症（MDD）是医学实践中最常见的疾病之一，也是全球致残的主要原因之一，常与焦虑症共病。伏硫西汀（Lu AA21004）是一种新型抗抑郁药，它结合了多种神经递质再摄取和受体效应，这些效应被认为可预测其作为抑郁和焦虑症治疗药物的疗效。
本综述总结了伏硫西汀的药理学和神经生物学。对其在重度抑郁症和广泛性焦虑症中的疗效和耐受性研究进行了批判性综述。
尽管行业资助的研究比其他临床试验更有可能支持实验药物的疗效，但结果不一。一些研究支持伏硫西汀在治疗MDD方面优于安慰剂，而另一些则不然。两项研究支持伏硫西汀治疗广泛性焦虑症的疗效，另外两项则不支持。不同研究中性功能障碍的发生率差异很大，但心脏效应和精神运动损害似乎最小。伏硫西汀相对于现有抗抑郁药的优势尚不清楚。
