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The Pharmacology and Clinical Use of the Antidepressants Vilazodone, Levomilnacipran, and Vortioxetine for Depression in the Elderly

  • Geriatric Psychiatry (GT Grossberg, Section Editor)
  • Published:
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Abstract

Treatment of depression in the elderly is particularly challenging due to the relative scarcity of well-designed trials, atypical clinical presentations, and presence of multiple comorbidities, particularly cognitive impairment. While meta-analyses involving antidepressants have generally shown modest treatment benefits in this population, clinicians treating geriatric patients must be especially mindful of issues regarding polypharmacy, drug metabolism, and adverse event profiles. This article will examine the potential role in the elderly of the three latest antidepressants approved by the US Food and Drug Administration: vilazodone (January 2011), levomilnacipran (July 2013), and vortioxetine (September 2013). Thus far, vortioxetine was shown to be efficacious and tolerable in the elderly. Sub-group analyses involving vilazodone and levomilnacipran appear to show a similar efficacy in older compared with younger adults, although these are limited by small sample sizes. Issues related to pharmacodynamics, safety, tolerability, and the unique features associated with these drugs are further discussed.

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William James Deardorff declares that he has no conflict of interest.

George T. Grossberg has received grants for his department from Actavis, Novartis, Accera, and Noven, and has received personal fees from Actavis, Takeda, Otsuka, Novartis, Genentech, and Roche.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Saint Louis University School of Medicine, 1438 South Grand Blvd, St Louis, MO, 63104, USA

    William James Deardorff & George T. Grossberg

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  1. William James Deardorff
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Deardorff, W.J., Grossberg, G.T. The Pharmacology and Clinical Use of the Antidepressants Vilazodone, Levomilnacipran, and Vortioxetine for Depression in the Elderly. Curr Geri Rep 4, 301–311 (2015). https://doi.org/10.1007/s13670-015-0140-y

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