Adverse effects of escitalopram and vortioxetine in young patients with depression: a retrospective comparative study

Abstract Background Depression is a serious mental disorder that impairs both psychological and physical functioning. When depression occurs in individuals in their 20s and 30s, it may adversely affect not only the continuation of academic or occupational activities but also interpersonal relationships in educational and workplace settings. Therefore, appropriate pharmacotherapy is essential for this patient population. Although several studies have evaluated newer antidepressants in recent years, detailed information regarding adverse effects in routine clinical practice remains limited, and studies focusing specifically on younger populations are scarce. The aim of this study was to compare the incidence and characteristics of adverse events associated with two newer antidepressants frequently prescribed to young patients in clinical practice, escitalopram (Lexapro ® ) and vortioxetine (Trintellix ® ), and to explore strategies for ensuring safe pharmacotherapy. Methods This retrospective study analyzed patients with depression who were prescribed escitalopram or vortioxetine between 2019 and 2024. Clinical data were collected from medical records, with a follow-up period of 3 months. Statistical analysis was performed using EZR, with a significance level set at p < 0.05. Results The incidence of adverse events was significantly higher in the vortioxetine group than in the escitalopram group. Among the observed adverse events, nausea occurred significantly more frequently in patients receiving vortioxetine. Furthermore, a lower incidence of nausea was observed among patients who received concomitant gastrointestinal medications. Conclusions The findings of this study suggest that concomitant gastrointestinal medication use may be associated with a lower incidence of nausea among young patients treated with vortioxetine. Although causal relationships cannot be established because of the retrospective study design, these findings may provide preliminary real-world evidence regarding the management of vortioxetine-associated nausea. Further prospective studies are needed to confirm these observations.