A prospective randomised open label comparative study of efficacy and safety of escitalopram versus sertraline in major depressive disorder in a tertiary care hospital.

BACKGROUND: Depression is a commonly occuring mental health disorder affecting all sectors of people worldwide. Mental health is equally emphasised as that of physical health. Depression, an exasperating disorder shows alarming hike in the present and recent past. Selective serotonin reuptake inhibitors are first choice of drugs for depression and frequently prescribed. Still it has not been possible to declare one particular drug to be more efficacious than the other. The purpose of this study is to compare two of the drugs from this class of SSRIs, namely Sertraline and Escitalopram, in terms of efficacy and safety among major depressive disorder patients. AIM OF THE STUDY: To compare the efficacy and safety of two anti depressants, Escitalopram and Sertraline in patients diagnosed with major depressive disorder in outpatient department of psychiatry in a tertiary care hospital in Chengalpattu. METHODOLOGY: After approval from Institutional Ethical Committee, 120 patients were recruited and randomised into either group A to receive Tab.Escitalopram 10-20mg/day or group B to receive Tab.Sertraline 50-200mg/day. Demographic details and complete history were recorded during enrolment. Clinical examination, screening with Hamilton depression rating scale and lab investigations were done at baseline. Efficacy was measured by response in terms of improvement of symptoms assessed by scoring with Hamilton Depression Rating Scale at baseline, at 4, 8, and 12 weeks. Safety was ensured by recording vitals of the patients and laboratory parameters at baseline, 4, 8, 12 weeks of study period. Safety was assessed by recording adverse drug reactions reported voluntarily or observed clinically or changes reported in lab investigation during follow up. RESULTS: Mean HAM-D score reduction from 20.77 to 8.75 in group A (Escitalopram) and 20.96 at baseline to 8.65 in group B (Sertraline) after 12 weeks therapy was statistically significant within groups. Response rate assessed by reduction of mean HAM-D score did not show statistically significant difference between two groups. The occurrence of adverse effects in sertraline group was higher than escitalopram group and this difference was found to be statistically significant (P=0.007). CONCLUSION: The study confirms that both Escitalopram and Sertraline are appropriate as first line drugs in treatment for depression. Both drugs showed equal efficacy in producing response and remission. Escitalopram was better tolerated with less number of reported adverse events than sertraline.