Box 1.

Case Vignette 1

Switching from SSRI to Vortioxetine Because of TESD

A 28-year-old woman with a 12-month history of MDD who has been effectively treated with an SSRI begins to experience diminished sexual functioning. Specifically, she reports loss of interest in sex and reduced ability to have an orgasm. She has a long-term partner and no other health concerns of note. Her PCC discusses the extent of the patient’s sexual dysfunction with her and decides to switch her from her current SSRI to vortioxetine 10 mg for 1 week, followed by an increase to 20 mg. On initial follow-up 1 month later, the patient reports a mild improvement in symptoms of TESD and good tolerability of vortioxetine. At another follow-up 1 month later, the patient reports a good response to treatment, with increased interest in sex and improvement in ability to have an orgasm. This is consistent with her responses on the Changes in Sexual Functioning Short-Form, which the PCC asks her to complete during her follow-up. The patient reports mild nausea and dizziness at this visit, but otherwise reports good tolerability. Her PCC asks to see her again in 3 months.