14 replies to this topic

[Perek]

At last a uniquely new antidepressant that is likely to be available pretty soon !

Mutimodal, broadspectra neuromodulator Vortioxetine was filed with EMEA yesterday for marketing approval in Europe.
FDA and Canada to follow later this year !

Apart from being antidepressive it also seem to have a cognitive enhancing effect and being pro-sexual.

In clinical trials it did "ok". 6 out 8 large studies proved significantly better than placebo. But to my knowledge no other drug has done any better anyway. There is simply no magic bullet for everyone but this one seem to be acting fast (after a week) and with very limited side-effects + with the cognitive and libido enhancing properties it's a drug that I'd love try try out asap.

[DaneV]

Ahh it looks like Lundbeck is looking for a new cash cow now that their patents on escitalopram are expering soon (or are expired in some countries). And if you only care about money you dont put your research in a real novel antidepressant drug, but you just release another shitty drug which main MOA is serotonin reuptake inhibition even though its clear serotonin is NOT the main factor in depression.

At least they came up with a completely new molecule this time instead of just removing one of the stereoisomers like they did last time to get a new patent.

Edited by DaneV, 21 September 2012 - 09:09 PM.

[Perek]

Sure, their $ 1.5 Bn a year es/citalopram cash cow is just about to get wide open for generic competition.
I think it's great. They been forced to come up with something quite new.
This one is not at all mainly about serotonin re-uptake inhibition that tend to flush your brain into being a happy cow.
It targets very specific serotonin receptors that downstream modulates neurotransmitters including dopmaine, noradrenalin, acth and histamine.

Right, more serotonin is no way to nirvana or just being you. But those other neurotransmitters are really hard to tweak with direct agonist/antagonist. At least for any therapeutic period of time. Like 2 months. Or life.

[DaneV]

Well I think the biggest problem with hitting other neurotransmitters (mainly dopamine) is that it actually does make people feel good and since some people want to feel even better then "good" the drug will be a candidate for abuse and addiction. And because abuse potential is the number 1 reason to get a drug rejected by the FDA, drug companies are looking for non-abusable but thereby ineffective methods of improving mood.

Look at amineptine. I`m not saying this drug didn`t have its issues, but it had a superior response rate to SSRI`s and is proven to work in the longer term but it got banned because of abuse potential. Same goes for ketamine; a great INSTANT antidepressant for a large group of depressive people but not generally available due to abuse potential and the fact that it`s not possible to get a patent on it anymore.

[Thorsten3]

Well I think It's an extremely interesting drug, and DaneV shouldn't really be making such sloppy comments if he doesn't know anything about pharmacology! (sorry, just an assumption based on your comments). Focussing in on the serotonin reuptake aspect of it is such a minimalist way of looking at it.

All of its actions are extremely interesting and in theory, this should be better than all the tripe that is out there which are classed 'antidepressants'.

The 5HT1A agonism will get rid of a lot of the annoying side effects that accompany a SSRI. The 5HT7 antagonism is antidepressive. As is the 5HT3 antagonism.

I know from first hand experience that adding a stimulating drug such as Trivastal to a boring, apathetic, bleh drug like Escitalopram can transform the experience into something completely different.

So, sorry, but it's not just another bullshit drug. It's something to be a bit optimistic about. Obviously, the only thing that provides reputation to these drugs are long term studies and success stories. But even without this, i would be willing to try it if it ever became available.

[DaneV]

I hope you`re right but looking at the clinical trails published on pubmed, there is nothing to be optimistic about. It wasn`t any better then placebo in two studies, one study showed a little more improvement in Vortioxetine vs placebo and one study was open label thus not worth much.

So at least in terms of crappy efficacy it sure looks like a SSRI...

Edited by DaneV, 27 September 2012 - 05:42 PM.

[Perek]

I think SSRI's are excellent antidepressants but usually not worth the side-effects.

Most studies are not published on pubmed yet and several are ongoing. They already got what they need to get approval with EMEA and FDA in terms of safety and effeciency. Current ongoing studies seem to be more about where they are going to position the drug in the marketplace. Any drugmanufactuers wet dream would be to introduce a new antidepressant that becomes a new first line treatment option. However, with almost all of the 2nd generation AD's now are or about to become off-patent and offered as generics at a typical1/5 of the original patented drug price. No insurer, national health service or private, are willing to pay 5 times more for a drug that only shows marginally better efficiency than cheap generic alternatives.

No analyst believes Vortioxetine will become available as a first-hand treatment for depression. I think Lundbeck will bombard drug agencies with studies showing not only its lack of side-effects compared to other AD's but also focus on parameters outside of the typical MADRS scores. Considering their resources it may be an eye opener to get drug agencies to realize the importance of other parameters that enhance the quality of life beyond being a happy cow with a limb stick.

I am eager to try Vortioxetine myself. I already written Lundbeck to ask if they got approval for the drug in other markets but the EMEA was their first regulatory filing. But I guess they, in parallell, will apply for marketing approval in other markets like Russia, Ukraine, Korea, Brazil...and if so the process tend to be very short and it should be possible to get it sooner via alternative means.

[Thorsten3]

SSRIs are excellent antidepressants. They obliterate depression. Totally kill it, stone cold. But, you are right. The SEs are there, and certainly intolerable for a lot of people.

For me, the downsides to SSRIs were;

1. Apathy
2. Not being able to feel happiness or sadness
3. Turning me into a different person (aloof, unemotional, detached) and uninterested in connecting with others
4. Made me slightly manic too, even when the drug settled
5. Made my SAD worse (but improved GAD.. It was awesome, for this)
6. I had one month of the worst mood ever when I gave the drug up (gave up mainly for reasons 1, 2 and 3)

The postives were;

1. Zero depression
2. Regular bowel movements (SSRIs are great in this area, research studies and links between serotonin and the bowel)
3. Zero inflammation
4. Improvement in symptons for my CFS
5. Great sleep
6. Didn't affect my sex drive at all, in fact, made me hornier (I was on a low dose of Lexapro though, a SSRI notorious for being the best of all the SSRIs for sexual function)
7. Cognition returned to normal (depression fucks this royally)
8. More confidence, expect in situations where my SAD disorder would be most vulnerable
9. Better ability to focus, not get stressed about stuff that would normally rot away at my poor brain!

Overall, the experience I had with one year on 1.25mg of Lexapro, taught me a lot of things about myself and my condition(s). I knew that it was time to move on though as the year approached. I wasn't developing as a person and it was as if I was surviving with a blanket around me. I went through the month (in my case) of withdrawal and came out far happier.

I would never recommend SSRIs to anyone, this is just my own personal experience.

Edited by Thorsten2, 29 September 2012 - 07:04 PM.

[Flex]

PSSD (post ssri sexual disorder) is a further complication due to SNRI or SSRI usage which can last for years i.e. total impotence (!!),

I would try to use first the older ones e.g. trycyclic or receptor inhibitors like Mirtazapine, trazodone & etc

Edited by Flex, 24 April 2015 - 06:48 PM.

[AlexCanada]

Would adding 1.5mg of Selegiline to Vortioxetine 5mg be relatively safe?  I reallyyy need something for Dopamine and norepinephrine and Vortioxetine isn't cutting it enough for me personally. My motivation and interest are exceptionally poor most of the time. 

[Michael Rian]

I am also on Vortioxetine, and while it does help my issues, I too feel the need to add something Dopamine related.  Would anyone have some suggestions?  As the poster stated above, Would Selegiline pair well with it perhaps?

 

Thank you for your time and insight.

[Diego55]

Has anyone tried this drug for anxiety disorders, such as social phobia ?

[AlexCanada]

Has anyone tried this drug for anxiety disorders, such as social phobia ?

 

Did not appear to do anything at all for my typically non-social mood.  Niacin post flush usually works wonders for this though. Too bad it can be so inconsistent. When Niacin works it's an absolute pro-social miracle. 

[sensei]

 

Has anyone tried this drug for anxiety disorders, such as social phobia ?

 

Did not appear to do anything at all for my typically non-social mood.  Niacin post flush usually works wonders for this though. Too bad it can be so inconsistent. When Niacin works it's an absolute pro-social miracle. 

 

 

Niacin and niacinimide act on the TSPO peripheral benzodiazepine receptors which modulate CNS neurotransmitters including GABA receptors in the brain by modulating neurosteroids which affect the ion channels of the GABA receptor and other receptor complexes.

 

Niacin potentiates the activity of many anticonvulsants.

Edited by sensei, 30 April 2015 - 01:40 AM.

[Diego55]

I have tired both Niacin and Niacinamide :

 

http://www.iherb.com...82&sr=null&ic=2

 

http://www.iherb.com...54&sr=null&ic=5

 

 

...neither of them worked for me, even in high doses.