Effect of vortioxetine vs. escitalopram on plasma BDNF and platelet serotonin in depressed patients.

Abstract

Escitalopram and vortioxetine are efficacious antidepressants. They directly target serotonin (5-HT) system, but vortioxetine mechanism of action is distinct from the one of selective serotonin reuptake inhibitors (SSRIs). Treatment with SSRIs decrease platelet 5-HT concentration and increase peripheral brain-derived neurotrophic factor (BDNF) levels. Since vortioxetine has a multimodal mechanism of action, it is expected to have a greater effect on circulatory BDNF concentration, compared to conventional antidepressants. This longitudinal study aimed to explore and compare the effects of 4-weeks of treatment with vortioxetine and escitalopram on plasma BDNF and platelet 5-HT concentration in patients with major depressive disorder (MDD). The results revealed that vortioxetine significantly increased plasma BDNF concentration (p = .018) and significantly decreased platelet 5-HT concentration (p < .001). Treatment with escitalopram significantly decreased platelet 5-HT concentration (p < .001), but it did not affect plasma BDNF concentration (p = .379). Response to vortioxetine was not predicted by baseline plasma BDNF or platelet 5-HT concentration, but response to escitalopram was predicted by baseline platelet 5-HT concentration. These effects might be due to vortioxetine unique mechanism of action, but the clinical implications are unclear. It remains to be determined whether this finding extends during long-term vortioxetine treatment, and which, if any, clinical effects emerge from BDNF increase.

• Authors: Anja Dvojkovic, Matea Nikolac Perkovic, Marina Sagud, Gordana Nedic Erjavec, Alma Mihaljevic Peles, Dubravka Svob Strac, Bjanka Vuksan Cusa, Lucija Tudor, Zorana Kusevic, Marcela Konjevod, Maja Zivkovic, Sasa Jevtovic, Nela Pivac
• Journal: Progress in neuro-psychopharmacology & biological psychiatry (Prog Neuropsychopharmacol Biol Psychiatry) Vol. 105 Pg. 110016 (03 08 2021) ISSN: 1878-4216 [Electronic] England
• PMID: 32534176 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Brain-Derived Neurotrophic Factor
• Serotonin
• Vortioxetine
• Escitalopram

Topics

• Adolescent
• Adult
• Aged
• Brain-Derived Neurotrophic Factor (blood)
• Depressive Disorder, Major (blood, drug therapy)
• Escitalopram (pharmacology, therapeutic use)
• Female
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Serotonin (blood)
• Vortioxetine (pharmacology, therapeutic use)
• Young Adult