Clinical Study to Compare the Effect of Antidepressant Drugs (Escitalopram and Sertraline) on Depression Improvement and Biomarker Alterations in Patients of Multidrug Resistant Tuberculosis with Depression

Objective: To compare the effect of Escitalopram and Sertraline on depression improvement and biomarker alterations in patients of MDR‐tuberculosis with depression. Methods: A randomized clinical trial was carried out in department of tuberculosis & respiratory diseases and department of psychiatry G.S.V.M. Medical College, Kanpur after getting approval from the institutional ethics committee. Total 50 MDR‐TB patients diagnosed with mild to moderate depression were enrolled in the study and randomly divided into two groups. First group (25 patients) was administered Escitalopram (10mg) and second group (25 patients) was administered Sertraline (50mg) along with standard MDR‐tuberculosis treatment. Depression improvement were assessed by Hamilton depression rating ( HDRS) score at day 15, 30, 60 and 120 whereas biomarker alterations ( serum lipid profile‐ serum cholesterol, triglyceride, LDL‐C, HDL‐C and VLDL cholesterol) were assessed at day 30 and 120. Data were compiled and statistically analyzed using SPSS 20.0, student t‐test and paired t ‐ test. Results: Total 19 patients in Escitalopram group and 18 in Sertraline group had completed the study. The mean reduction in HDRS score were not statistically significant (p>0.05) between the groups whereas within the groups this reduction were significant (p<0.001). Amongst the lipid profile parameters, Sertraline showed a significant increase in serum cholesterol (p<0.001) as compared to Escitalopram. The rest of the lipid profile parameters were not increased significantly (p>0.05). Conclusion: Escitalopram and Sertraline have comparable efficacy in reducing the symptoms of depression in MDR‐TB patients. Sertraline had significant effect on biomarker (serum cholesterol only) in comparison to Escitalopram.