COMPARATIVE EVALUATION OF THE EFFICACY AND SAFETY OF SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS) AND SEROTONIN–NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS) IN THE TREATMENT OF MAJOR DEPRESSIVE DISORDER: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
SSRIs,, SNRIs, major depressive disorder, antidepressants, efficacy, tolerability
Abstract
Background: SSRIs and SNRIs are among the most widely prescribed antidepressants. Comparative data on their relative efficacy and tolerability in real-world Indian settings remain limited.
Objective: To compare the efficacy, safety, and tolerability of SSRIs and SNRIs in patients with Major Depressive Disorder (MDD).
Methods: A prospective observational study was conducted over 6 months in the Psychiatry and Pharmacology Departments of a tertiary care hospital. A total of 120 patients diagnosed with MDD (DSM-5 criteria) were enrolled—60 received SSRIs (fluoxetine, escitalopram, sertraline) and 60 received SNRIs (venlafaxine, duloxetine). Efficacy was assessed using the Hamilton Depression Rating Scale (HAM-D) at baseline, 4 weeks, and 8 weeks. Adverse effects were documented using a standardized checklist. Statistical analysis was performed using paired t-test and chi-square test.
Results: Baseline HAM-D scores were comparable (SSRI: 23.4 ± 4.2; SNRI: 23.8 ± 3.9; p = 0.62).
At 8 weeks, both groups showed significant improvement (SSRI: 11.6 ± 3.4; SNRI: 9.9 ± 3.2; p = 0.02).Response rates (≥ 50% reduction in HAM-D) were 71.6% for SSRIs and 80% for SNRIs.
Common adverse effects: SSRIs—nausea (25%), headache (18%), sexual dysfunction (20%); SNRIs—dry mouth (23%), insomnia (20%), dizziness (15%).Dropout rates: SSRI 8.3%, SNRI 10%.
Conclusion: Both SSRIs and SNRIs are effective for MDD. SNRIs demonstrated marginally superior efficacy, while SSRIs were better tolerated. Choice of therapy should be individualized.
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Dr Syed Sujat
Assistant professor, Department of pharmacology, Alameen medical college, Vijayapur, Karnataka, India
Dr Lakshmipathi B S2
Associate Professor, Department of Pharmacology, Koppal Institute of Medical Sciences, Koppal, Karnataka, India
Dr Sha Naseeruddin Makandar
Assistant professor, Department of Pharmacology, Kanachur institute of medical sciences, Natekal, Mangalore, Karnataka, India