A COMPARATIVE STUDY OF EFFICACY, SAFETY, AND ONSET OF ACTION OF VILAZODONE WITH ESCITALOPRAM IN PATIENTS OF MAJOR DEPRESSIVE DISORDER AT TERTIARY CARE HOSPITAL
Keywords:Efficacy, Vilazodone, Escitalopram, Major depressive disorders
Objective: To compare efficacy, safety, and onset of action of Vilazodone with Escitalopram in treatment of major depressive disorder (MDD).
Methods: A prospective, randomized, active-controlled, and parallel–group comparative open label study was conducted among 92 patients of MDD attending psychiatry OPD of a tertiary care center. They were divided into control and experimental groups receiving Escitalopram and Vilazodone, respectively. Hamilton depression rating scale (HAM-D), Hamilton anxiety rating scale (HAM-A), Montgomery-Asberg depression rating scale (MADRS), clinical global impression improvement (CGI-I), and CGI-severity (CGI-S) scores were assessed at the end of 1st, 2nd, 4th, and 12th weeks in both the groups.
Results: There was significant decrease in HAM-D, HAM-A, MADRS, CGI, and CGI-S scores in control as well as the experimental groups. Experimental group receiving Vilazodone showed significant decrease in the scores as compared to control group (p<0.001) at the end of 2nd and 4th week. Although the number of adverse effects were more in the Vilazodone group leading to higher score on UKU scale, the difference was not statistically significant.
Conclusion: The present study showed clinical advantages of use of Vilazodone over Escitalopram with improvement in all the scores. Significant reduction in scores was seen as early as 1 week in Vilazodone group which justifies its early onset of action and superiority over selective serotonin reuptake inhibitors.
Bathla M, Anjum S, Singh M, Panchal S, Singh GP. A 12-week comparative prospective open-label randomized controlled study in depression patients treated with vilazodone and escitalopram in a tertiary care hospital in North India. Indian J Psychol Med 2018;40:80-5.
Available from: https://www.who.int/mediacentre/factsheets/fs369/en
Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020; Global burden of disease study. Lancet 1997;349:1498-504.
Goodwin RD, Kroenke K, Hoven CW, Spitzer RL. Major depression, physical illness, and suicidal ideation in primary care. Psychosom Med 2003;65:501-5.
Leon AC, Olfson M, Broadhead WE, Barrett JE, Blacklow RS, Keller MB, et al. Prevalence of mental disorders in primary care. Implications for screening. Arch Fam Med 1995;4:857-61.
Spitzer RL, Kroenke K, Linzer M, Hahn SR, Williams JB, deGruy FV 3rd., et al. Health-related quality of life in primary care patients with mental disorders: Results from the PRIME-MD 1,000 study. JAMA 1995;274:1511-7.
Kudyar P, Gupta BM, Khajuria V, Bansal R. Comparison of efficacy and safety of escitalopram and vilazodone in major depressive disorder. Natl J Physiol Pharm Pharmacol 2018;8:1147-52.
Heinrich T, Bottcher H, Schiemann K, Hölzemann G, Schwarz M, Bartoszyk GD, et al. Dual 5-HT1A agonists and 5-HT reuptake inhibitors by combination of indole-butyl-amine and chromenonyl piperazine structural elements in a single molecular entity. Bioorg Med Chem 2004;12:4843-52.
Blier P, Ward NM. Is there a role for 5-HT1A agonists in the treatment of depression? Biol Psychiatry 2003;53:193-203.
Bielski RJ, Cunningham L, Horrigan JP, Londborg PD, Smith WT, Weiss K. Gepirone extended-release in the treatment of adult outpatients with major depressive disorder: A double-blind, randomized, placebo-controlled, parallel-group study. J Clin Psychiatry 2008;69:571-7.
Gammans RE, Stringfellow JC, Hvizdos AJ, Seidehamel RJ, Cohn JB, Wilcox CS, et al. Use of buspirone in patients with generalized anxiety disorder and co existing depressive symptoms. A meta-analysis of eight randomized, controlled studies. Neuropsychobiology 1992;25:193-201.
Robinson DS, Rickels K, Feighner J, Gammans RE, Shrotriya RC, Alms DR, et al. Clinical effects of the 5-HT1A partial agonists in depression: A composite analysis of buspirone in the treatment of depression. J clin Psychopharacol 1990;10:67S-76.
Available from: https://cdscoonline.gov.in>cdsco
Schwartz TL, Siddiqui UA, Stahl SM. Vilazodone: A brief pharmacological and clinical review of the novel serotonin partial agonist and reuptake inhibitor. Ther Adv Psychopharmacol 2011;1:81-7.
American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder. 5th ed. Arlington: American Psychiatric Publishing; 2010. p. 1-152.
Penninx BW, Milaneschi Y, Lamers F, Vogelzangs N. Understanding the somatic consequences of depression: Biological mechanisms and the role of depression symptom profile. BMC Med 2013;11:129.
Shweta C, Singh PS. Is vilazodone really the answer to the delay associated with the onset of antidepressant action of SSRIs? A randomized control trial. Int J Clin Psychiatry 2018;6:9-18.
Stahl SM. Combining antidepressant therapies from the initiation of treatment: A paradigm shift for major depression. J Clin Psychiatry 2009;70:1493-4.
Rickels K, Athanasiou M, Robinson DS, Gibertini M, Whalen H, Reed CR. Evidence for efficacy and tolerability of vilazodone in the treatment of major depressive disorder: A randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 2009;70:326-33.
Khan A, Cutler AJ, Kajdasz DK, Gallipoli S, Athanasiou M, Robinson DS, et al. A randomized, double-blind, placebo-controlled, 8-week study of vilazodone, a Serotonergic agent for the treatment of major depressive disorder. J Clin Psychiatry 2011;72:441-7.
Hedlund JL, Viewig BW. The hamilton rating scale for depression: A comprehensive review. J Oper Psychiatry 1979;10:149-65.
Mathews M, Gommoll C, Chen D, Nunez R, Khan A. Efficacy and safety of Vilazodone 20 and 40 mg in major depressive disorder: A randomized, double blind, placebo-controlled trial. Int Clin Psychopharmacol 2015;30:67-74.
Shi L, Wang J, Xu S, Lu Y. Efficacy and tolerability of vilazodone for major depressive disorder: Evidence from phase III/IV randomized controlled trials. Drug Des Devel Ther 2016;10:3899-907.
Gommoll C, Forero G, Mathews M, Nunez R, Tang X, Durgam S, et al. Vilazodone in patients with generalized anxiety disorder: A double-blind, randomized, placebo-controlled, flexible dose study. Int Clin Psychopharmacol 2015;30:297-306.
Wang SM, Han C, Lee SJ, Patkar AA, Masand PS, Pae CU. Vilazodone for the treatment of major depressive disorder: Focusing on its clinical studies and mechanism of action. Psychiatry Investig 2015;12:155-63.
Khan A, Sambunaris A, Edwards J, Ruth A, Robinson DS. Vilazodone in the treatment of major depressive disorder: Efficacy across symptoms and severity of depression. Int Clin Psychopharmacol 2014;29:86.
Targum SD, Hassman H, Fava M. Development of a clinical global impression scale for Fatigue. J Psychiatr Res 2012;46:370-4.
Robinson DS, Daniel KK, Gallipoli S, Whalen H, Wamil A, Reed CR. A 1-year open label study assessing the safety and tolerability of vilazodone in patients with major depressive disorder. J Clin Psychopharmacol 2011;31:643-6.
Croft HA, Pomara N, Gommoll C, Chen D, Nunez R, Mathews M. Efficacy and safety of Vilazodone in major depressive disorder: A randomized, double-blind, placebo- controlled trial. J Clin Psychiatry 2014;75:1291-8.
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