New frontiers in depression treatment: vilazodone and vortioxetine as multimodal options

During the Masterclass Psychiatry 2025, new frontiers in depression treatment were explored, including vilazodone and vortioxetine. This article synthesizes the key insights.

Depression is a heterogeneous and multifactorial condition that requires personalized therapeutic approaches. The development of antidepressants with multimodal mechanisms represents a significant advance beyond SSRIs. In this context, vilazodone and vortioxetine stand out as two molecules approved in recent decades.

Vilazodone

Vilazodone combines selective serotonin reuptake inhibition with partial agonism at the 5‑HT1A receptor, which may potentiate anxiolytic and antidepressant effects. Randomized trials have shown efficacy in reducing depressive symptoms with prominent anxiety, along with favorable functional improvement.

Vortioxetine

Vortioxetine is considered a multimodal antidepressant: beyond serotonin reuptake inhibition, it modulates serotonin receptors (5‑HT1A agonism; 5‑HT3 and 5‑HT7 antagonism, among others). This broad activity is associated with improvements in mood, cognition, and anhedonia, with less impact on sexual and metabolic adverse effects than some SSRIs.

Therapeutic individualization

Choice should consider the predominant symptom profile: vilazodone for depression with marked anxiety; vortioxetine for patients with cognitive impairment or predominant anhedonia. Both expand remission chances and quality of life when integrated into personalized treatment plans.

#Vilazodone #Vortioxetine #DepressionTreatment #Psychopharmacology #PersonalizedMedicine

Editorial note: This content was developed with the support of artificial intelligence technologies to optimize writing and information structuring. All material was carefully reviewed, validated, and complemented by human experts before publication, ensuring scientific accuracy and adherence to good editorial practices.