Vilazodone Efficacy Shown in Difficult-to-Treat Populations

The antidepressant vilazodone reduced depressive symptoms in patients with characteristics previously linked with reduced response to antidepressants, researchers reported in International Clinical Psychopharmacology.

In a post-hoc analysis of data pooled from 4 trials, a study team broke down results by subgroups of patients—based on sex, age, duration of depression, episode recurrence, current episode duration, and baseline total score on the Montgomery-Åsberg Depression Rating Scale (MADRS). Reduced efficacy of antidepressants has previously been reported in men, older people, patients with a longer duration of major depressive disorder (MDD), and patients with recurrent depression.

The trials included 1254 patients treated with vilazodone and 964 patients given a placebo. Total score improvement from baseline to week 8 on the MADRS was significantly greater among patients taking vilazodone, compared with patients taking a placebo, in the full population and in all subgroups.

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Researchers also measured rates of response (≥50% MADRS total score improvement) and remission (MADRS total score ≤10). Those rates significantly separated from placebo in all subgroups, with two exceptions: remission in patients with very severe baseline symptoms (MADRS score ≥35) and response and remission in patients with a current episode duration of 12 months or longer. In those subgroups, numerical differences were seen, in favor of vilazodone, but they were not statistically significant.

“A clinically meaningful treatment effect was found in all of the subgroups included in this post-hoc analysis,” researchers wrote. “Vilazodone may be an effective treatment option for heterogenous populations of adults with MDD regardless of sex, age, baseline symptom severity, or MDD history.”

The study was funded by Forest Research Institute, Inc., an affiliate of Allergan, which markets vilazodone as Viibryd. Vilazodone is a selective serotonin reuptake inhibitor and 5-HT_1A receptor partial agonist.

—Terri Airov

Reference

Kornstein S, Chang C, Gommoll C, Edwards J. Vilazodone efficacy in subgroups of patients with major depressive disorder: a post-hoc analysis of four randomized, double-blind, placebo-controlled trials. International Clinical Psychopharmacology. 2018 April 6;[Epub ahead of print].