BackgroundMajor depressive disorder (MDD) and alcohol use disorder (AUD) are highly comorbid, with greater clinical complexity and psychosocial impairment. Several antidepressants have been used in this population, with mixed results. This preliminary study aims to investigate the effects of the multimodal antidepressant vortioxetine in MDD + AUD subjects.MethodsWe retrospectively evaluated 57 MDD + AUD and 56 MDD outpatients, matched for baseline characteristics. Patients were assessed after 1, 3, and 6 months treatment with vortioxetine (10-20 mg/d, flexibly dosed) in combination with continuous psychosocial support. The primary outcome was improvement in depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale. We also investigated changes in anxiety, anhedonia, cognition, functioning, quality of life, and clinical global severity using the following instruments: Hamilton Anxiety Rating Scale, Snaith-Hamilton Pleasure Scale, Digit Symbol Substitution Test, Perceived Deficits Questionnaire-Depression, Functioning Assessment Short Test, Quality of Life Index, and Clinical Global Impression-Severity Scale.ResultsVortioxetine significantly improved mood in MDD + AUD patients (P < .001), with no differences when compared to MDD (P = .36). A substantial rate (45.6%) of comorbid subjects obtained clinical remission at endpoint (P = .36 vs MDD). We additionally observed baseline to endpoint improvements on all secondary outcomes (P < .001), with no significant difference between groups. Overall, vortioxetine was safe and well tolerated.ConclusionsGiven its effectiveness on mood, cognition, and functioning, its good safety and tolerability profile, and low potential for abuse, vortioxetine could represent a valid pharmacological intervention in MDD + AUD patients as part of an integrated therapeutic-rehabilitation program.

中文翻译：

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沃替西汀对重度抑郁症和酒精使用障碍患者的影响：为期 6 个月的回顾性分析

背景重度抑郁症 (MDD) 和酒精使用障碍 (AUD) 高度共病，具有更大的临床复杂性和社会心理障碍。在这一人群中使用了几种抗抑郁药，结果喜忧参半。这项初步研究旨在调查多模式抗抑郁药 vortioxetine 在 MDD + AUD 受试者中的作用。方法我们回顾性评估了 57 名 MDD + AUD 和 56 名 MDD 门诊患者，与基线特征相匹配。患者在接受 vortioxetine（10-20 mg/d，灵活给药）联合持续心理社会支持治疗 1、3 和 6 个月后进行评估。主要结果是通过蒙哥马利-埃斯伯格抑郁量表测量的抑郁症状改善。我们还调查了焦虑、快感缺失、认知、功能、生活质量的变化，磷< .001)，与 MDD (磷= .36)。相当比例（45.6%）的共病受试者在终点获得临床缓解（磷= .36 与 MDD）。我们还观察到所有次要结果的基线到终点的改善（P < .001），组间没有显着差异。总体而言，vortioxetine 是安全且耐受性良好的。结论鉴于其对情绪、认知和功能的有效性、良好的安全性和耐受性以及低滥用可能性，vortioxetine 可以代表 MDD + AUD 患者的有效药物干预，作为综合治疗的一部分治疗康复计划。