Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases
Abstract Background Jitteriness/anxiety syndrome is a recognized adverse effect observed during the initiation or change of dose in antidepressant treatment. Managing patients who develop this syndrome remains a challenge. While escitalopram is a widely used antidepressant known to cause these sympt...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | PCN Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pcn5.158 |
| _version_ | 1797375121591107584 |
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| author | Kaoru Arai Mari Nonaka Shoko Shimada Masayuki Nakamura |
| author_facet | Kaoru Arai Mari Nonaka Shoko Shimada Masayuki Nakamura |
| author_sort | Kaoru Arai |
| collection | DOAJ |
| description | Abstract Background Jitteriness/anxiety syndrome is a recognized adverse effect observed during the initiation or change of dose in antidepressant treatment. Managing patients who develop this syndrome remains a challenge. While escitalopram is a widely used antidepressant known to cause these symptoms, this report explores vortioxetine as a therapeutic alternative. Case Presentation Three distinct clinical scenarios were observed in patients who manifested jitteriness/anxiety syndrome while on escitalopram treatment for depression. Patient A was initiated on escitalopram and experienced an initial alleviation in depressive symptoms, but 3 months later displayed mood elevation, talkativeness, and increased activity, which disturbed his daily life. A transition to vortioxetine subsequently resolved the mood elevation. Patient B exhibited elevated mood, hyperactivity, irritability, and talkativeness just 6 days post‐initiation of treatment with escitalopram. After the discontinuation of escitalopram and unsuccessful trials with aripiprazole, lurasidone, and lamotrigine, her depressive mood intensified, culminating in suicidal ideation. Starting vortioxetine led to a consistent improvement of her symptoms, and she resumed work and was emotionally stable. Patient C was initially diagnosed with bipolar disorder and faced a relapse into depression despite undergoing various treatments. After 2 weeks on escitalopram, she exhibited irritability and self‐harm urges. Three months later, after being re‐diagnosed with depressive disorders with anxious distress, vortioxetine was administered, which significantly reduced her depressive symptoms and allowed her to continue her education. Conclusion Vortioxetine presents as a promising therapeutic alternative that is worth considering for patients with escitalopram‐induced jitteriness/anxiety syndrome. |
| first_indexed | 2024-03-08T19:17:38Z |
| format | Article |
| id | doaj.art-85385766038f405eb28047934374c8dd |
| institution | Directory Open Access Journal |
| issn | 2769-2558 |
| language | English |
| last_indexed | 2024-03-08T19:17:38Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | PCN Reports |
| spelling | doaj.art-85385766038f405eb28047934374c8dd2023-12-27T04:00:46ZengWileyPCN Reports2769-25582023-12-0124n/an/a10.1002/pcn5.158Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three casesKaoru Arai0Mari Nonaka1Shoko Shimada2Masayuki Nakamura3Department of Psychiatry Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Psychiatry Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Psychiatry Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Psychiatry Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanAbstract Background Jitteriness/anxiety syndrome is a recognized adverse effect observed during the initiation or change of dose in antidepressant treatment. Managing patients who develop this syndrome remains a challenge. While escitalopram is a widely used antidepressant known to cause these symptoms, this report explores vortioxetine as a therapeutic alternative. Case Presentation Three distinct clinical scenarios were observed in patients who manifested jitteriness/anxiety syndrome while on escitalopram treatment for depression. Patient A was initiated on escitalopram and experienced an initial alleviation in depressive symptoms, but 3 months later displayed mood elevation, talkativeness, and increased activity, which disturbed his daily life. A transition to vortioxetine subsequently resolved the mood elevation. Patient B exhibited elevated mood, hyperactivity, irritability, and talkativeness just 6 days post‐initiation of treatment with escitalopram. After the discontinuation of escitalopram and unsuccessful trials with aripiprazole, lurasidone, and lamotrigine, her depressive mood intensified, culminating in suicidal ideation. Starting vortioxetine led to a consistent improvement of her symptoms, and she resumed work and was emotionally stable. Patient C was initially diagnosed with bipolar disorder and faced a relapse into depression despite undergoing various treatments. After 2 weeks on escitalopram, she exhibited irritability and self‐harm urges. Three months later, after being re‐diagnosed with depressive disorders with anxious distress, vortioxetine was administered, which significantly reduced her depressive symptoms and allowed her to continue her education. Conclusion Vortioxetine presents as a promising therapeutic alternative that is worth considering for patients with escitalopram‐induced jitteriness/anxiety syndrome.https://doi.org/10.1002/pcn5.158depressionescitalopramjitteriness/anxiety syndromeselective serotonin reuptake inhibitorvortioxetine |
| spellingShingle | Kaoru Arai Mari Nonaka Shoko Shimada Masayuki Nakamura Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases PCN Reports depression escitalopram jitteriness/anxiety syndrome selective serotonin reuptake inhibitor vortioxetine |
| title | Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases |
| title_full | Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases |
| title_fullStr | Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases |
| title_full_unstemmed | Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases |
| title_short | Vortioxetine as a potential alternative for patients with escitalopram‐induced jitteriness/anxiety syndrome: A report of three cases |
| title_sort | vortioxetine as a potential alternative for patients with escitalopram induced jitteriness anxiety syndrome a report of three cases |
| topic | depression escitalopram jitteriness/anxiety syndrome selective serotonin reuptake inhibitor vortioxetine |
| url | https://doi.org/10.1002/pcn5.158 |
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