Box 2.

Case Vignette 2

Vortioxetine for Elderly Patient with Cognitive Issues

A 74-year-old man recently diagnosed with MDD complains of having difficulty concentrating. Comorbidities include high blood pressure and a history of asthma; concurrent medications are lisinopril and a bronchodilator. As part of the clinical workup, Alzheimer’s disease was ruled out, and a Mini-Mental State Exam was performed, with a resulting score of 29/30. After a discussion with the patient about his treatment options, the patient was prescribed vortioxetine at the full dose, as dose reductions are not required based on age. However, due to the age of the patient, his PCC monitored for signs and symptoms of hyponatremia, such as nausea, confusion, and headache, as elderly patients on antidepressants are at increased risk for this. At a follow-up visit 1 month later, the patient was tolerating vortioxetine well and did not report any signs or symptoms of hyponatremia but did report feeling nauseous at times and having dry mouth. At a 3-month follow-up visit, the patient reported improvement in symptoms of depression and ability to concentrate.