Comparative study of efficacy and safety of escitalopram versus opipramol in the treatment of major depressive disorder: one-year, prospective, open label, randomized and add on therapy in a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20261950Keywords:
Depression, Escitalopram, Opipramol, HAM-A, HAM-D, CGI-severity of illness, Global improvement, Efficacy indexAbstract
Background: A randomized, prospective, open label, comparative study was conducted to evaluate and compare the Efficacy and safety of escitalopram versus opipramol in patients suffering from major depressive disorder (MDD).
Methods: A total of 100 patients from psychiatry OPD diagnosed with major depression were included in the study after fulfilled the inclusion and exclusion criteria. The eligible participants were randomly allocated into one of the following two treatment groups after randomization block permeation method i. e., pharmacologically equivalent dose range of the two drugs as follows: group 1: Tab. escitalopram 10-20 mg OD for 6 weeks. Group 2: Tab. opipramol 50 mg-100 mg BD for 6 weeks. All patients were given the respective tablets for 2 week and were asked to come for follow up after 2nd, 4th and 6th week of treatment. At first visit baseline parameters like weight, BMI, CBC, LFTs, RFTs, lipid profile, blood glucose, ECG and use of concomitant medicines were recorded and subsequently measured again at the end of 4th and 6th week. Evaluation parameters were assessed by using HAM (D and A) scale and Naranjo causality assessment scale.
Results: Escitalopram group exhibited a better improvement in HAM-D score in comparison to Opipramol group. Escitalopram group exhibited a better improvement in CGI-SOI, CGI-GI, CGI-EI score in comparison to Opipramol group. On intergroup comparison, no statistically significant difference (p<0.05) was seen between the groups at 6 weeks of treatment. It was observed that 32 patients in Escitalopram arm and 35 patients in opipramol group required the rescue treatment (tab. Clonazepam).
Conclusions: we conclude from our study that escitalopram group showed better improvement in management of symptoms of depression than opipramol.
References
American Psychological Association Guideline Development Panel for the Treatment of Depressive Disorders. APA Policy. 2019.
American Psychiatry Association. Diagnostic and Statistical manual of mental disorders. 5th Arlington, VA: American Psychiatric Publishing. 2013.
WHO. The Global Burden of Disease: 2004 update. 2008. Available at: http://www.who.int/healthinfo. Accessed on 15 March 2026.
Pattanayak RD, Sagar R. Depressive Disorders in Indian Context: A Review and Clinical Update for Physicians. J Associat Physic India. 2014;62(9):827-32.
Montgomery S, Hansen T and Kasper S. Efficacy of escitalopram compared to citalopram:a meta-analysis. Int J Neuropsuchopharmacol. 2011;14:261-68.
Landy K, Rosani A, Estevez R. Escitalopram. In: Stat Pearls. 2023;10.
Karunarathna I, Hapuarachchi T, Gunasena P, Aluthge P, Perera N, Gunathilake S, et al Escitalopram: Mechanism, Pharmacology, and clinical use in depression and anxiety. ResearchGate. 2024.
Krysta K, Murawiec S, Warchala A, Zawada K, Cubała WJ, Wiglusz MS, et al. Modern indications for the use of opipramol. Psychiatr Danub. 2015;27(1):S435-7.
Moller HJ, Volz HP, Reimann IW, Stoll KD. Opipramol for the treatment of somatoform disorders results from a placebo controlled trial. Europ Neuropsychopharmacol. 2000;10:211-7.
Naranjo CA Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. Naranjo Adverse Drug Reaction Probability Scale Modified from: A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239¬-45.
Hamilton M. Scale for depression. Matrix. 1960;23(1):56-63.
Aryal S, Chakrabarti K, Gupta M. A comparative study on efficacy of amitriptyline and escitalopram in the treatment of depression. Int J Basic Clin Pharmacol. 2018;7:234-7.
Li C, Li C, Huo N, Mishuk AU, Hansen RA, Harris I, et al. Generic escitalopram initiation and substitution among medicare beneficiaries: A newer user cohort study. National centre for Biotechnology Information. PLoS One. 2020;15(4):e0232226.
Guanjun Li, Shen Y, Luo J, Li H. Efficacy of escitalopram monotherapy in the treatment of major depressive disorder. Medicine (Baltimore). 2017;29(39):96.
Gupta BM, Zargar SH, Arora M, Tandon VR. Efficacy and safety of escitalopram versus desvenlafaxine in the treatment of major depression: A preliminary 1-year prospective randomized open label comparative trial. Perspect Clin Res. 2016;7(1):45-50.
Manjunath H, Shashikala GH, Somashekar HS, Babool R, Prashanth D. Opipramol versus escitalopram in the treatment of generalized anxiety disorder. WJPR. 2016;5:2
Krysta K, Murawiec S, Warchala A, Zawada K, Cubała WJ, Wiglusz MS, et al. Modern indications for the use of opipramol. Psychiatr Danub. 2015;27(1):S435-7.
Urade CS, Mahakalkar SM, Tiple PG. A comparative study of the clinical efficacy and safety of agomelatine with escitalopram in major depressive disorder patients: A randomized, parallel-group, phase IV study. J Pharmacol Pharmacother. 2015;6(4):198-203.
Barritt JM, McGuiness BW, Beaumont G. Opipramol and trifluoperazine in the treatment of anxiety and tension. Gen Practit. 1969;17(83):395.
Carpene C, Les F, Mercader J, Gomez-Zorita S, Grolleau J L, Boulet N, et al. Opipramol Inhibits Lipolysis in Human Adipocytes without Altering Glucose Uptake and Differently from Antipsychotic and Antidepressant Drugs with Adverse Effects on Body Weight Control. Pharmaceuticals. 2020;13(3):41.
Downloads
Published
How to Cite
Issue
Section
