A comparative prospective open label randomized controlled 8 week study in patients of depression treated with vilazodone and sertraline

Background: Depression is a mood disorder treated with various antidepressant such as SSRIs due to lesser toxicity and improved safety profile.Methods: This was an eight week randomised active controlled parallel group study. 54 patients were allocated in two group. Group A received vilazodone while group B received sertraline. Assessment done at baseline, 2, 4 and 8 weeks on the basis of clinical efficacy, sexual dysfunction, side effects and weight gain using Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Arizona Sexual Experience Scale (ASEX) and UKU Side Effect Rating Scale.Results: HAM-D score of group A was 18.78±1.78 and 7.67±1.66 while in group B was 19.04±2.12 and 8.15±1.77 at baseline and 8 weeks respectively. HAM-A score of group A was 15.44±1.50 and 6.63±1.39 while in group B was 15.26±1.83 and 7.07±1.14 at baseline and 8 weeks. ASEX total score of group A was 15.63±1.28 and 14.63±1.33 while group B was 15.52±1.37 and 16.41±1.12 at baseline and 8 weeks. ASEX desire score of group A was 9.63±0.93 and 8.67±0.88 while of group B was 9.59±0.93 and 10.07±0.92 at baseline and 8 weeks. UKU side effect rating at 2 and 8 weeks of group A was 0.22±0.42, 1.04±0.76 while in group B was 0.37±0.49, 1.89±0.85.Conclusions: Vilazodone and Sertraline are equally efficacious in treatment of depression and associated anxiety. When side effect profile were compared Vilazodone is found superior to Sertraline

Escitalopram add-on in stable Schizophrenia with subsyndromal depression

Background: Significant proportion of the patients of schizophrenia suffer from subsyndromal symptomatic depressive symptoms (SSD) which not only add to the burden of disease but also to the already pre-existing challenges of living with this serious mental illness. Many psychiatrists prescribe antidepressants to patients with schizophrenia who have subsyndromal symptomatic depressive symptoms but data regarding SSD in schizophrenia is meagre. Aim was to study the effect of addition of Escitalopram on psychopathology, cognition and functioning in patients with stable schizophrenia having subsyndromal depressive symptoms and to compare these parameters with patients treated with antipsychotics alone.Methods: The study was a prospective, 8-week randomized double-blind placebo-controlled trial. Seventy four patients who fulfilled the diagnostic criteria of Schizophrenia on the basis of the ICD10-DCR, adjudged to be stable clinically and not requiring any increase in dose of antipsychotic medication over the last eight weeks were recruited into the study. The patients randomly received either Antipsychotics with add-on Escitalopram (10 mg/day) or Antipsychotics with placebo for 8 weeks. The patients were assessed using the HAM-D, CDRS, PANSS, SCoRS, SOFAS and CGI scores at the end of 8 weeks. Patients were also assessed for adverse events at baseline, week 4 and week 8.Results: A total of sixty-six patients who completed the study were analyzed. The HAM-D, CDRS and PANSS score showed significantly better cognition and functioning in the patients of add-on Escitalopram group when compared with the placebo group. There was no significant difference between the two groups in terms of observed side effects.Conclusions: Escitalopram addition to the standard anti-psychotic treatment of schizophrenia, in patients having subsyndromal depressive symptoms, results in better cognition and improved functioning.

PARFLEX--a very useful drug for management of surgical pain.

The aim was to assess and document the efficacy and tolerability of parflex (FDC of aceclofenac with paracetamol and serratiopeptidase) in management of pain and inflammation in adult patients undergoing surgical procedures (or operations). The design was open, prospective, non-comparative and multi-dose study of patients undergoing surgical procedures at a leading, tertiary-care, teaching hospital (setting) in Lucknow, the name being, King George's Medical College, Lucknow 226003. The patients were 50 adult patients of either sex undergoing surgery. They were given 1 tablet twice daily, taken after meals. Treatment duration was for a total of up to 7 days (intervention). Primary efficacy variables were relief from postoperative pain. Secondary efficacy variables were global assessment of efficacy and toleration by patients and treating physicians. Record was made of spontaneously reported adverse events with their nature, intensity and outcome (tolerability). Out of 50 patients, 31% were (ENT), 36% were (Orthopaedic) and 33% were (Gynaecology). They were enroled in this study. The observations made were mean pain score showed significant improvement with study drug - decreasing from 2.66 at baseline to 1.36 after 48 hours, and to 0.8 at the end of study. Composite score for pain, fever and swelling also showed substantial gains visit-on- visit-decreasing from 3.62 at baseline to 2.04 after 48 hours, and to 0.98 at final visit. None of the patients reported any adverse event. Global efficacy assessment was rated as 'excellent or good' by 54% of patients and in 59% of patients by their treating physicians. To conclude, parflex is an effective analgesic, anti-inflammatory drug that has a valuable therapeutic option for controlling pain and inflammation after surgical procedures.