Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression

Authors

  • Meghna Shinde Department of Pharmacology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Uttar Pradesh, India
  • Pooja Reddy Department of Pharmacology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Uttar Pradesh, India
  • Mohit Kulmi Department of Pharmacology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Uttar Pradesh, India
  • Chhaya Goyal Department of Pharmacology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20181489

Keywords:

Escitalopram, HDRS, Milnacipran, SSRI, SNRI

Abstract

Background: The present prospective, open labelled study was designed to evaluate the efficacy and tolerability of escitalopram, selective serotonin reuptake inhibitors (SSRI) in comparison with milnacipran, dual serotonin and noradrenaline reuptake inhibitors (SNRI) in the treatment of major depressive disorder.

Methods: Outpatients (N=120) with an ongoing/newly diagnosed ICD-10 major depressive episode and having a minimum score of 8 on the 21-item Hamilton Depression Rating Scale (HDRS) were assigned to escitalopram, 10–20 mg/day (54 patients) and milnacipran 50-100mg (66 patients), for an 8 week treatment period with follow up at 2nd, 4th and 8th week. The parameters for efficacy were improvement (decrease in HDRS scores at 8 weeks from baseline values), response (decrease of ≥50% in the HDRS scores) and remission (HDRS score of ≤7). Tolerability was assessed by comparing the frequency of adverse effects and drop out rate due to the same at the end of 2nd, 4th and 8th week in both the groups.

Results: Improvement, Response rate and Remission rates at the end of eight weeks were 71.11%, 83.33% and58.33% for escitalopram and 59.35%, 34.14% and75.6% for milnacipran respectively. Adverse experiences were reported by 14% of patients in escitalopram group and 79.2% patients in milnacipran group at 8 weeks. Additionally, there were significantly lesser dropouts due to adverse events in escitalopram (3.70%) than in milnacipran group (30%).

Conclusions: Escitalopram, the Senantiomer of citalopram, is a safe and effective antidepressant with potentially superior tolerability and comparable efficacy to the dual reuptake inhibitor, Milnacipran.

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Published

2018-04-23

How to Cite

Shinde, M., Reddy, P., Kulmi, M., & Goyal, C. (2018). Efficacy and tolerability of milnacipran and escitalopram: a comparative study among patients of depression. International Journal of Basic & Clinical Pharmacology, 7(5), 839–843. https://doi.org/10.18203/2319-2003.ijbcp20181489

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Original Research Articles