Depression and HIV/AIDS are closely interlinked. HIV-positive patients are at increased risk of depression due to the encounter with several negative life events such as HIV-related stigma and bias, sexual dysfunction, long-term physical despair and ailment, adverse effects of antiretroviral therapy (ART), financial crises and unemployment, and dispute with families and others. 

A recent study assessed the prevalence of depression and the changes in depression symptoms following agomelatine and escitalopram drug therapy in HIV-positive patients suffering from mild to moderate depression.

The study enrolled HIV-positive patients on antiretroviral therapy reporting to the ART center who were screened for depression as per the International Classification of Diseases. The enrolled patients were randomized into two groups to receive either agomelatine (25 mg/day) or escitalopram (10 mg/day). The severity of depression was assessed using the HAMD scale at baseline and each follow-up visit. 

Of the 194 HIV-positive patients on ART screened, 56 (28.87%) patients were found to be suffering from depression. Of these 56 patients 64.28%, 30.36%, and 5.36% of patients suffered from mild, moderate, and severe depression, respectively. 

A total of 49 patients were enrolled, among which only 40 completed the study. Both groups of patients showed clinically relevant and statistically significant changes from baseline to subsequent visits within-group HAMD scores. 

Further, the in-between-group differences in HAMD scores were statistically significant, with a greater reduction in score with escitalopram than with agomelatine. 

Thus, there is a marked prevalence of depression among people living with HIV/AIDS, which highlights the intimidating need to include mental health care including routine screening and treatment for mental disorders to optimize patient care, and improve quality of life and health outcomes. Escitalopram has significantly higher efficacy than agomelatine regarding the early response and better relief from symptoms of depression.

Source; International Journal of Pharmaceutical Research. 2021;13(3). DOI: https://doi.org/10.31838/ijpr/2021.13.03.007