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

Background: Depression is a leading cause of morbidity in modern world and introduction of selective serotonin reuptake inhibitors (SSRIs) was a revolution for treating depression. However, sexual dysfunction and weight gain always remained an issue for patients leading to discontinuation of treatment. Vilazodone is a novel SSRI and literature show better efficacy and decrease weight gain and sexual dysfunction. Aim of study: This study aims to compare the efficacy, sexual dysfunction, and weight gain caused due to vilazodone and escitalopram. Methodology: This is an open-label randomized, controlled study; 60 patients diagnosed as depression were divided into two groups of 30 each. One group was started on vilazodone and one on escitalopram randomly. The groups were compared on the basis of efficacy, weight gain, and sexual dysfunction by applying Hamilton Depression Rating Scale (HDRS) and Arizona Sexual Experience Scale (ASEX) at baseline, 4, and 12 weeks interval. Statistical analysis was done by applying Chi-square, t-test, and fisher exact test and descriptive analysis. Results: Vilazodone group shows fall in HDRS with 18.77 +/- 4.3, 14.83 +/- 3.68, and 9.63 +/- 3.06 while it was 18.8 +/- 4.09, 14.3 +/- 2.96, and 8.43 +/- 2.1 at baseline, 4, and 12 weeks, respectively. ASEX score in vilazodone was found to have 16.87 +/- 2.97, 15.37 +/- 3.1, and 11.73 +/- 3.55 while on escitalopram, 16.4 +/- 3.35, 17.13 +/- 3.48, and 18.37 +/- 4.09 at first visit, 4, and 12 weeks, respectively. Patients on vilazodone had mean weight of 69.63 +/- 7.7, 69.83 +/- 7.83, and 69.9 +/- 7.69 while on escitalopram, 72.47 +/- 7.95, 72.87 +/- 7.9, and 75.6 +/- 8.46 at baseline, 4, and 12 weeks, respectively. Conclusions: Our study shows that vilazodone has better efficacy, lesser weight gain, and lesser sexual dysfunction.