Efficacy and Safety of Escitalopram in First Episode of Major Depressive Disorder - A Tertiary Care Indian Center Experience

Context: Major Depressive Disorder (MDD) is the most prevalent psychiatric illness and escitalopram is one of the most commonly used selective serotonin reuptake inhibitors (SSRI) for its treatment. Aim: To study efficacy and safety of escitalopram in patients with first episode of MDD. Materials and methods: This was a prospective, open label, eight weeks follow-up study. Eighty-four patients with first episode of MDD were selected using simple random sampling. Depression was diagnosed using DSM-5 diagnostic criteria for MDD. Montgomery-Asberg Depression Rating Scale (MADRS) was used to assess the severity of depression. Clinical Global Impression Severity (CGI-S) and Clinical Global Impression Improvement (CGI-I) were used to measure illness severity and global improvement. The Antidepressant Side-Effect Checklist (ASEC) was used to measure adverse reactions to antidepressants. Results: The mean of MADRS total score at baseline was 32.08 which was decrease in subsequent follow up and at 8-week score was 11.24. 77% of patients responded (≥50% or more reduction of MADRS total score) and 64.9% remitted (≤12 score of MADRS) at 8 weeks. 22.9% of patients reported side effects during the 8-week treatment. 94.2% of patients got significant improvement with 10 mg dose of escitalopram. The common side effects were constipation (5.4%), nausea (5.4%), dry mouth (4.1%) and yawning (4.15%). Conclusion: Escitalopram treatment was efficacious and well tolerated in patients with first episode of MDD. Nearly two third patients achieved remission at the end of eight week.