Major depressive disorder (MDD) is a common mental disorder often associated with deficits in cognitive function. The Diagnostic and Statistical Manual 5 (DSM-5) lists impairment in cognition (i.e. diminished ability to think or concentrate or indecisiveness) as a criterion item in the diagnosis of a major depressive episode (MDE).

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are each associated with high rates of sexual dysfunction. One long-term study, for example, estimated that sexual dysfunction was nearly twice as common in people with MDD as in the general population. Pharmacotherapy for MDD or GAD can alleviate sexual dysfunction in some patients, but treatment with most antidepressants is itself associated with some form of sexual dysfunction or worsening sexual dysfunction. As many as 30%–80% of patients treated with selective serotonin reuptake inhibitors (SSRIs) experience some form of treatment-emergent sexual dysfunction (TESD), which can affect any aspect of sexual activity, including desire, arousal, and orgasm. Sexual dysfunction associated with antidepressant use reduces self-esteem and quality of life and burdens interpersonal relationships. It is particularly bothersome to patients and may affect treatment compliance. Escitalopram is a frontline antidepressant. Few studies have examined cognitive and sexual functioning after being treated with antidepressants involving vortioxetine.

We expect vortioxetine to perform better than escitalopram in cognitive and sexual functioning and at least as well as Escitalopram in treating symptoms of depression.