Comparison of escitalopram a new SSRI with TCA, clomipramine in major depressive disorder: a double blind study

ABSTRACT

To compare efficacy and side effects of a new Selective Serotonin re-uptake inhibitor antidepressant Escitalopram with Tricyclic antidepressants; Clomipramine in-patients suffering from major depressive illness. Design: A prospective longitudinal study. Setting: Outpatient Psychiatric Cinic at Services Hospital, Lahore. Patients and Method: Patients between the age range of twenty to fifty five years suffering from Major depressive illness according to DSM-IV diagnostic criteria were included in the study. Ten patients receiving escitalopram were matched with ten patients from a larger sample of Clomipramine treated patients in regard to age, sex and diagnosis to create clinically comparable groups. Montgomery Asberg Depression rating scale and Demographic Performa on the formatted patterns were applied for assessing depression and other details. The raters who were from other group were blind to the patient's medication status. The efficacy of both the drugs is comparable. The onset of action was earlier in escitalopram group. The side effects of a newer drug were much less than the older Tricyclic antidepressant NSSRI. The new drug Escitalopram is better tolerated and has a rapid onset of action. The older TCA Clomipramine showed the same response if the patients tolerate side effects but it had relatively delayed onset of action