Expert’s preference on escitalopram and clonazepam for treating depression and anxiety in Indian diabetic and hypertensive patients

Objective: The present study aims to identify the prevalence of anxiety and depression in patients with diabetes mellitus (DM) and hypertension (HTN) in India and assess the expert opinion on the treatment choices for these patients, specifically involving escitalopram and clonazepam. Methodology: The cross-sectional, questionnaire-based study collected data through a multiple-response questionnaire. The questionnaire comprised 38 questions, covering various aspects such as the prevalence, symptoms, and treatment options for anxiety and depression in patients with HTN and DM. Results: Of the 242 respondents, 52% and 41% reported that anxiety and depression are the most common psychiatric conditions reported in HTN and DM patients. The majority of respondents (66.53%) preferred using selective serotonin reuptake inhibitors (SSRIs) for treating these patients. In patients who were unresponsive to initial treatment with an anxiolytic medication, approximately 35% of specialists recommended switching to another anxiolytic medication within the same class. According to 36% and 32% of respondents, around 51-75% of these patients reported improvement in anxiety or depressive symptoms after receiving either escitalopram or clonazepam. To prevent dropout in these patients, nearly 42% of responders recommended initiating low-dose combination medications. Conclusion: In HTN and DM patients, SSRIs and benzodiazepines are recommended for the treatment of anxiety and depression. The experts highly recommend escitalopram and clonazepam medications in these patients for improvement in depression and anxiety levels. However, experts suggest initiating treatment with low-dose combination medications to prevent dropout and for the management of anxiety and depression.