# Efficacy of Vortioxetine Versus Escitalopram on the Cognitive Profile of Patients With Depressive Disorder: A Comparative Study

## TL;DR

This study compares how well vortioxetine and escitalopram improve cognitive function in patients with depression, finding that both drugs help, with escitalopram showing a slight edge.

## Contribution

The study provides a direct comparison of two antidepressants' effects on cognitive function in depression, revealing a modest advantage for escitalopram.

## Key findings

- Both vortioxetine and escitalopram improved cognitive function in MDD patients over four weeks.
- Escitalopram showed a slight advantage in Montreal Cognitive Assessment (MoCA) scores by week four.

## Abstract

Background: Major depressive disorder (MDD) is a prevalent mental health condition with significant cognitive impairments, affecting millions worldwide. Cognitive dysfunction in MDD, encompassing attention, memory, executive function, and processing speed deficits, increases the disease burden and impacts treatment outcomes. Vortioxetine, a multimodal antidepressant, and escitalopram, a selective serotonin reuptake inhibitor, have both been utilized for MDD treatment, yet their comparative effects on cognitive function remain under-explored.

Aim: This study aimed to compare the effects of vortioxetine and escitalopram on cognitive function in patients with MDD.

Methodology: This prospective, randomized follow-up study (October 2023-2024) assessed 150 MDD patients meeting the following criteria: Montreal Cognitive Assessment Scale (MoCA) score ≤ 26 and Brief Cognitive Rating Scale (BCRS) score ≥ 1. Patients were randomly assigned to escitalopram (10 mg, n = 78) or vortioxetine (10 mg, n = 72), with 50 per group analyzed at the final evaluation. Cognitive function was assessed using MoCA and BCRS at baseline, week two, and week four.

Results: Both vortioxetine and escitalopram improved cognitive function over four weeks. While the reduction in BCRS scores showed no statistically significant difference between the groups, MoCA scores indicated a slight advantage for escitalopram by the fourth week (p = 0.05). These findings suggest that both drugs effectively improve cognitive function, with escitalopram demonstrating a slight cognitive advantage over the study period.

Conclusion: Both vortioxetine and escitalopram improve cognitive symptoms in MDD, with escitalopram showing a modest cognitive advantage by the 4th week. These results support the efficacy of both medications for cognitive symptoms in MDD, with escitalopram potentially offering a slight edge in cognitive enhancement. Further long-term studies are warranted to confirm these findings and investigate the underlying neurobiological mechanisms.