The opinion article is devoted to the analysis of a large-scale comprehensive systematic review of relevant and practically oriented studies of vortioxetine use in depression for the period to 2020. The mechanisms of multimodal action, issues of efficacy and safety of the drug, including direct procognitive effects, effects on anhedonia, anxiety, sleep disorders, analgesic and anti-inflammatory effects are highlighted. An increase in the efficacy of vortioxetine when the dose is increased to 20 mg/day is emphasized. Prospective directions for antidepressant research are outlined.