Is Vilazodone Really the Answer to the Delay Associated with the Onset of Antidepressant Action of SSRIs? – A Randomised Control Trial

Aims and Objectives: To assess and compare the onset of antidepressant actions of esitalopram, fluoxetine, sertraline and paroxetine with vilazodone. Methodology: One hundred and fifty patients diagnosed with Depression according to the DSM 5 criteria, seen in the Out-patient department of psychiatry at a tertiary care hospital, participated in the study after obtaining written and informed consent. Thirty patients each were randomly assigned to treatment with either of the following drugs: esitalopram, fluoxetine, sertraline, paroxetine and vilazodone. Montgomery Asberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HAM-D) were applied on Day 1 to assess the baseline severity of Depressive features and again at week 1, week 2 and week 8 following initiation of treatment, to assess the extent of improvement, if any, along with onset of antidepressant action with various drugs. Results were tabulated using SPSS v20 and independent sample t tests were applied. Results: While all the drugs showed a decrease in depressive symptoms, Vilazodone was associated with significant differences between the day 1 and week 1 values of both MADRS and HAM-D scores as compared to other antidepressants in the study. Conclusion: The relatively faster onset of antidepressant action associated with Vilazodone can be useful in treating severe depression especially in those associated with suicidal tendencies and can thus be useful in achieving response and remission in patients suffering from Depression.