The antidepressant response is a complex feature affected by clinical, demographic, and genetic factors.

A recent study thus explored the influences of baseline depression severity, gender and type of depressive episode on the efficacy and safety of escitalopram (10–20 mg/day) in South Indian patients with major depressive disorder (MDD).

The study enrolled 151 patients aged between 18-65 years suffering from a first or recurrent episode of MDD with a 17-item Hamilton Depression Rating Scale (HDRS-17) score of ≥ 18 at baseline. Efficacy was evaluated employing HDRS-17, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression (CGI) at baseline and weeks 4, 8 and 12. Adverse drug reactions (ADRs) were monitored. Clinical results were compared among different groups based on gender, type of depressive episode (first or recurrent episode) and baseline HDRS-17 scores (moderate depression—score between 17 and 23; severe depression—score ≥ 24).

148 subjects completed the 12-week study. 43.9% and 42.6% of them achieved response and remission, respectively. The decline in HDRS-17 and MADRS scores from baseline was found significant at all follow-up visits. CGI also showed similar improvement. Efficacy results were more promising in the moderate baseline depression group than in the severe depression. No associations were found between efficacy, gender, and type of depressive episode. 

In all, 247 adverse drug reactions (ADR) were documented and 80.41% of subjects encountered at least one ADR during the study period, however, none of them were severe. Male patients encountered more ADRs than females. The safety profile of escitalopram was identical across different groups based on baseline depression severity and type of depressive episode.

This study indicated that escitalopram is efficacious in south Indian MDD patients with a favourable safety profile. The efficacy was affected by baseline depression severity and more ADRs were documented in male patients.

Egypt J Neurol Psychiatry Neurosurg. 2021; 57. https://doi.org/10.1186/s41983-021-00302-7