Dear Professor Wegener and Dear Authors,

It has come to my attention that the systematic review entitled ‘Apathy associated with antidepressant drugs: a systematic review’ (Masdrakis et al., Reference Masdrakis, Markianos and Baldwin2023) published in Acta Neuropsychiatrica in January did not include our study entitled “Effectiveness of vortioxetine on emotional blunting in patients with major depressive disorder with inadequate response to selective Serotonin Reuptake Inhibitor (SSRI)/selective Serotonin and Norepinephrine Reuptake Inhibitor (SNRI) treatment” (Fagiolini et al., Reference Fagiolini, Florea, Loft and Christensen2021), although it met the inclusion and exclusion criteria and had relevant results.

Our data (Fagiolini et al., Reference Fagiolini, Florea, Loft and Christensen2021) discuss the relevance of SSRI/SNRI-induced apathy and evaluate the efficacy, safety, and tolerability of an antidepressant that may not cause it, with a design that could be considered relatively similar to other included studies.

Our study addressed the relevance of apathy caused by SSRI/SNRI treatment and evaluated the efficacy, safety, and tolerability of vortioxetine, an antidepressant that does not cause emotional blunting, in the studied population.

The main findings of the study were that switching from an SSRI/SNRI antidepressant treatment associated with emotional blunting symptoms to vortioxetine 10-20 mg effectively improved emotional blunting, global functioning, motivation and energy, cognitive performance, and depressive symptoms in patients with Major Depressive Disorder (MDD) with partial response to SSRI/SNRI therapy and emotional blunting, which are the crucial data to be included in any systematic review intended to evaluate all publications regarding apathy/emotional blunting manifestations in patients undergoing pharmacotherapy with any antidepressant agent. The absence of this study in the review gives the impression that there are no clinical data on vortioxetine in relation to apathy/emotional blunting in major depressive disorder, which is not accurate.

Based on the study’s adherence to the inclusion and exclusion criteria, its alignment with the search criteria and data interval, and the relevance of its findings to the daily clinical practice of mental health professionals, my coauthors and I would be grateful if the authors would consider including our study in their systematic review.

Sincerely.

Thank you for your attention to this matter. I look forward to your response.

Sincerely,