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

Abstract

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.

The antidepressant drug vilazodone is an allosteric inhibitor of the serotonin transporter

“…The common side effects of VLZ include nausea, diarrhea, and headaches, which are also common for other SSRIs. In contrast, VLZ is not as frequently associated with a reduction in sexual dysfunction [49][50][51] , the most common cause of discontinuation of SSRI treatment 52 . Also, weight gain is reduced with VLZ treatment relative to other SSRIs [49][50][51] .…”

“…In contrast, VLZ is not as frequently associated with a reduction in sexual dysfunction [49][50][51] , the most common cause of discontinuation of SSRI treatment 52 . Also, weight gain is reduced with VLZ treatment relative to other SSRIs [49][50][51] . However, despite these intriguing properties, the molecular basis for VLZ binding to SERT remains an open question.…”

Effectiveness and side-effect profile of Vilazodone and Escitalopram in major Depressive Disorder – An observational study

“…1 In a 12-week comparative prospective open-label randomized controlled study in depression patients treated with vilazodone and escitalopram, Manish Bathla et al, 2018 reported that more females were receiving treatment as compared to males, which is in agreement with our results. 14 The HAM-D scores calculated during the study were significantly lowered by vilazodone and escitalopram (P < 0.001). On intergroup comparison using independent t-test, vilazodone was found to cause more lowering of HAM-D score than escitalopram (P < 0.02).…”

“…13 In a 12-week comparative prospective open-label randomized controlled study conducted in north India comparing the efficacy and safety of escitalopram and vilazodone in MDD, vilazodone has been found to have better efficacy, lesser weight gain, and lesser sexual dysfunction. 14 Kudyar P et al reported that escitalopram was more efficacious and better tolerated than vilazodone in patients with MDD. 8 This observational study is undertaken with the aim to assess the effectiveness and side effects of vilazodone and escitalopram in patients diagnosed with major depressive disorder.…”

A comparative prospective open label randomized controlled 8 week study in patients of depression treated with vilazodone and sertraline

“…An open label randomized controlled study in depression showed that for the patient treated with vilazodone the ASEX score at 12 weeks was 11.73±3.55 (in this study ASEX total score were 14.63±1.33 at 8 week). 17 In another study conducted on the effect of sertraline on sexual functioning in patients with major depressive disorder the ASEX total score at baseline was 19. 13 A study on treatment emergent sexual dysfunction related to antidepressants shows that sertraline has higher rate of sexual dysfunction such as sexual desire, sexual arousal.…”