Effect of Selective Serotonin Reuptake Inhibitors on Psychomotor Function in Patients of Depression: A Comparative Study of Sertraline and Fluoxetine.

Aims and objectives: Depression is a most common and widespread of all psychiatric disorders. Treatment of depression includes the use of antidepressants, commonly used clinically, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitor, and monoamine oxidase inhibitors. Certain antidepressants apart from improvement in the symptoms found to have detrimental effect on cognitive and psychomotor functions. Objective of this study was to assess and to compare the effect of sertraline and fluoxetine on cognitive and psychomotor functions. Materials and methods: Effect of sertraline and fluoxetine on psychomotor function was assessed by using critical flicker fusion frequency (CFF) and reaction time (RT) in patients of mild to moderate depression at the end of 2nd and 4th week of mono therapy. Results: Patients in both the group have their RT remained significantly higher (p < 0.001) in comparison with control and CFF remained significantly lower at the end of both the week except sertraline group in which CFF did not differ significantly from control at the end of 4th week. There was a significant rise in CFF (p < 0.05) in sertraline group as compared to fluoxetine. Sertraline showed a significant improvement (p < 0.01) in visual reaction time (VRT) at both the follow-ups and auditory reaction time (ART) (p < 0.01) at 4th week of monotherapy. Both the groups did not differ with respect to their effect on choice reaction time (CRT). Conclusion: Findings of this study support the use of sertraline which had shown less impairment of psychomotor function in patients of depression as compared to fluoxetine, in special subgroups of population who operate machinery, drive vehicle or require alertness for the work.

Perception and attitudes of medical students toward communication, chronic disease and death.

Background: Medical students of today’s world found difficulty in communication when they faced with dying patients, how they would feel, what are their perception about caring of patients with chronic disease. These are often unspoken and neglected issues. Methods: It was a cross-sectional comparative questionnaire based survey of the 2nd year medical students and interns. Students were evaluated using a questionnaire consisting of 15 Likert type statements. Results: Completed questionnaire received from 89 out of 100 students. All students strongly agreed upon the commutation with patients. Interns (37.03%) were strongly disagreed (p=0.001) on not curing the patient is a failure of doctors. Interns (32.58%) were significantly more likely to be less worried (p<0.01) about death of the patient and to indicate cancer is a non-curable disease (p<0.001) when compared to 2nd MBBS. Students from both the groups distressed, while communicating with dying patients and relatives of dying patients. Conclusion: Perception of students regarding caring of chronically ill-patients and death related issues needs improvement. We believe that integrating different teaching strategies and training programs regarding this issue should begin at early stages of undergraduate medical curriculum.