Analysis of Side Effects in Major Depressive Patients  receiving Imipramine, Sertraline and Escitalopram therapy.

Arun  Kumar Sharma; Sunil Kumar Mathur

Arun Kumar Sharma Senior Demonstrator, Department of Pharmacology, JLN Medical College, Ajmer (Raj.)
Sunil Kumar Mathur Senior Professor & Head, Department of Pharmacology, JLN Medical College, Ajmer (Raj.)

Keywords: Depression, imipramine, sertraline and escitalopram.

Abstract

ABSTRACT

Background: Depression is a major cause of disability worldwide and third leading cause of global disease burden. Antidepressants medications remain a mainstay of treatment for major depressive disorder (MDD). Antidepressant side effects included insomnia, sleepiness during the day, restlessness, muscle spasm, dry mouth, profuse sweating, sexual disorders, nausea, constipation, diarrhoea, weight gain and dizziness. After obtaining the approval from the institutional ethics committee, this open label, observational and comparative study was conducted in patients of depressive disorder visiting OPD (Out Patient
Department) of psychiatric department of JLN Medical College & Associate group of Hospitals, Ajmer (Rajasthan). Study subjects (total- 810, sample size was calculated by ANOVAtest) meeting the inclusion/exclusion criteria were randomly assigned into three groups containing, 270 patients in each group were treated with imipramine, sertraline and escitalopram respectively as per scheduled. Tolerability was assessed and analysed by observing the side effects in above study patients at 4 weeks, 8 weeks, and 12 weeks.
We observed that imipramine and sertraline had relatively and significantly higher side effects as compared to escitalopram.
Dropout cases were maximum seen with imipramine therapy while it was seen minimum with escitalopram.
Conclusion: Escitalopram appears to be the best tolerated SSRI because of its additional mechanism (allosterically modulate the affinity of ligand at the primary site) which makes it unique among SSRI antidepressants. Overall it is concluded from present study that escitalopram is more tolerable in comparision to imipramine and sertraline.