BACKGROUND AND OBJECTIVE: Vortioxetine and duloxetine are two new antidepressant 
drugs that have been used clinically in the treatment of major depressive 
disorder (MDD). The objectives of this meta-analysis were to evaluate the 
efficacy and tolerability of vortioxetine compared with duloxetine in MDD.
METHODS: Randomized controlled trials (RCTs) published in PubMed, EMBASE, Web of 
Science, and ClinicalTrials.gov were systematically reviewed to compare 
vortioxetine with duloxetine in terms of efficacy and tolerability in patients 
with MDD. Results were expressed as the risk ratio (RR) with 95 % confidence 
intervals (CIs), and weighted mean difference (WMD). Pooled estimates were 
calculated by using a fixed-effects model or a randomized-effects model, 
depending on the heterogeneity among studies.
RESULTS: A total of five RCTs involving 2287 patients met the inclusion criteria 
and were included in this meta-analysis. Pooled results showed that duloxetine 
was associated with a higher response rate than vortioxetine, as well as showing 
a similar remission rate with vortioxetine. The changes from baseline in the 
Montgomery-Åsberg Depression Rating Scale (MADRS), 24-item Hamilton Rating Scale 
for Depression (HAM-D24), Clinical Global Impression-Improvement scale (CGI-I), 
CGI-Severity scale (CGI-S), Sheehan Disability Scale (SDS), and Hamilton Anxiety 
Rating Scale (HAM-A) scores were significantly greater in the duloxetine group 
than in the vortioxetine group. The incidence of treatment-emergent adverse 
events was significantly higher in the duloxetine group than in the vortioxetine 
group.
CONCLUSION: Duloxetine was more effective but less well-tolerated than 
vortioxetine in MDD. Considering the potential limitations of this 
meta-analysis, more large-scale RCTs are needed to confirm these findings.