Abstract

COMPARATIVE EVALUATION OF EFFICACY AND SAFETY OF ZIPRASIDONE VERSUS QUETIAPINE AUGMENTATION WITH ESCITALOPRAM IN PATIENTS OF MAJOR DEPRESSIVE DISORDER

Sahil Sharma*, Jarnail Singh and Hitesh Khurana

Abstract

Many patients of depression suffering from depression do not improve or show a partial response to conventional antidepressant therapy. Augmentation with atypical antipsychotics enhances the antidepressant action and builds on partial remission. This study was carried out to compare ziprasidone & quetiapine augmentation with escitalopram in patients with major depressive disorder (MDD). It was a prospective, open-label, randomized, comparative clinical study. At the end of 6 weeks with escitalopram (20 mg per day), the eligible patients, showing inadequate response to treatment, were randomly allocated to 2 treatment groups; augmented with quetiapine 200 mg once daily or ziprasidone 20 mg twice daily orally for 6 weeks. Key inclusion criteria were adult patients who met criteria for MDD as defined by DSM-5, and with inadequate clinical response to escitalopram 20mg per day for 6 weeks and HAM-D score of 15 or more on 17 item version, at the screening of the study. Key exclusion criteria were depression with psychotic features and bipolar disorder. Efficacy was assessed using Beck's depression inventory (BDI) scores at 2, 4, and 6 weeks. The baseline BDI score was (33.15 ± 0.678) in the quetiapine group and (32.35±0.466) in the ziprasidone group. BDI score was significantly reduced to (11.40 ± 0.320) & (10.65 ± 0.233) at 6 weeks in quetiapine and ziprasidone groups respectively. All the ADRs were of mild Grade, and none of them warranted any discontinuation of treatment, and augmentation of antidepressant therapy with quetiapine and ziprasidone was found to be safe and effective.

Keywords: MDD, DSM-5, BDI, Ziprasidone, Quetiapine, Escitalopram.