Abstract
Background: Major depressive disorder (MDD) is a worldwide prevalent psychiatric ailment associated with significant morbidity and mortality. Escitalopram is an effective selective serotonin reuptake inhibitor (SSRI), and vilazodone is a newer SSRI and partial serotonin receptor agonist approved for MDD.

Aims and Objectives: The aim was to evaluate and compare the efficacy and safety of escitalopram and vilazodone in patients of MDD.

Materials and Methods: The present, randomized study was conducted in a tertiary care teaching institute, and 50 patients between 18 and 55 years of either sex diagnosed with MDD based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria were included in the study. Patients were assigned randomly into two groups to receive orally either escitalopram (10 mg) or vilazodone (20 mg) and baseline scores of Hamilton Anxiety Scale (HAM–A) and Hamilton Depression Rating Scale (HAM-D) were recorded. These were then assessed at 6 weeks for post-drug scores and compared with baseline using Mann–Whitney and Wilcoxon signed-rank test statistical analytic method. Intergroup comparison was also done.

Results: Average age of the patients taken was 39.74 ± 8.6 years with a male:female ratio of 19:31. The HAM-D score was significantly lowered by both escitalopram and vilazodone (P < 0.0001). HAM-A score was also similarly lowered by escitalopram (P < 0.0001) and vilazodone (P < 0.0001). On intergroup comparison, escitalopram was found to cause more lowering of HAM-D score and HAM-A score than vilazodone (P < 0.0001). Biochemical profile (blood sugar, serum urea, creatinine, hemoglobin, and total leukocyte counts) was not altered with either of the drugs over 6 weeks. No significant adverse drug reactions were noted with the drugs.

Conclusion: Both drugs are effective in decreasing depression and anxiety scores in patients of MDD. On comparison, escitalopram was found better than vilazodone.