COVID-19 pandemic has witnessed >3- fold higher levels of depressive symptoms than before. A vast majority of post-COVID patients experience persistent fatigue, dyspnea, and neuropsychological symptoms. Persistent mental problems with critical levels of anxiety, depression, and post-traumatic stress disorder are seen in COVID-19 survivors, 1 year after discharge. 

Although the available studies on psychological distress have focused on social anxiety and lockdown measures, a mental disorder due to COVID-19 may be a great deal in the future. Thus, the effective psychopharmacological treatment of this problem needs to be explored. 

A recent study evaluated the efficacy of 10- week escitalopram monotherapy in relieving the symptoms of depression in survivors of COVID-19. It enrolled 33 patients who experienced COVID-19 infections and assessed the depressive symptoms that emerged during the recovery period. The mean age of the participants (including 75.65% females and 24.24% males) was 37.54 ± 8.97 years, whose depression was assessed by 17-item Hamilton Depression Scale. The intervention involved the addition of a 10 mg/day (20 in cases of severe depression) dose of escitalopram to standard therapy for post-COVID syndrome for 10 weeks. A paired t-test then evaluated the difference in depressive symptoms pre-and post-treatment. 

The results described the mean score on Hamilton Depression Scale before escitalopram prescription to be 15.57 ± 4.16 points. Before treatment 30.3% of participants reported symptoms of mild depression, 42.42% reported symptoms of moderate and 27.27% reported symptoms of severe depression. Age, gender, and depressive symptoms did not show any correlation. 

After 10-week treatment, the mean score on Hamilton Depression Scale reduced to 5.72 ± 2.87 points. 63.64% of the participants reported no symptoms of depression, 30.30% reported symptoms of mild depression and 3.03% reported symptoms of moderate depression. Thus, a decrease in the score from the baseline of 9.84 ± 4.63 points was found, which was irrespective of age or gender. 

This study confirms the common presence of depressive symptoms in patients in the recovery period after COVID-19. Treating these patients with escitalopram may be quite effective in reducing the symptoms of depression in patients. However, it will be interesting to study the persistence of this effect, which was not evaluated in this study. 

Source: Eur Neuropsychopharmacol. 2021 Dec; 53: S270.