Depression and cerebrovascular atherosclerosis often occur in comorbidity 
showing neuropsychological impairment and poor response to antidepressant 
treatment. Objective is to evaluate if new antidepressant vortioxetine may be a 
potential treatment option. Mechanism of Action : Vortioxetine has 5-HT3, 5-HT7 
and 5-HT1D antagonists, 5-HT1B partial agonist and a 5-HT1A agonist and 
serotonin transporter inhibitor property. Efficacy and safety in Major 
Depressive Disorders and in cognitive impairment : The majority of trials (one 
of them in older people) showed efficacy for vortioxetine against placebo and no 
differences against other active treatments. The Adverse Effects ranged from 
15.8% more to 10.8% less than placebo. In the elderly, only nausea was found 
higher than placebo. Effects on arterial blood pressure and cardiac parameters 
including the ECG-QT segment were similar to placebo. Elderly depressive 
patients on vortioxetine showed improvement versus placebo and other active 
comparators in Auditory Verbal Learning Test and Digit Symbol Substitution Test 
scores. The inclusion criteria admitted cases with middle cerebrovascular 
disease. Conclusion : The mechanism of action, the efficacy on depression and 
safety profile and early data on cognitive impairment make Vortioxetine a strong 
candidate for use in depression associated with cerebrovascular disease. This 
information must be supported by future randomized controlled trials.