Depression is the most common mood disorder affecting the population of all age groups with considerable impact on the quality of life with increased morbidity and mortality, imposing a great burden on the individual, family and society. The increasing prevalence of depression is of global concern regarding the cost of health care, loss of earning thus raising the interest in cost-benefit analysis in treating depression with the available therapies.

Even though depression can be treated by non-pharmacological methods like psychotherapy, electroconvulsive therapy and phototherapy, pharmacological approach remains the mainstay of the treatment. Currently, several classes of effective antidepressants are available such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs) and atypical antidepressants.

SSRIs are the generally preferred drugs as primary option because of their high efficacy, safety and tolerability. Escitalopram (S-enantiomer of citalopram) is one of the most widely prescribed SSRI because of its good tolerability and minimal drug interactive potential. Desvenlafaxine, an SNRI, is one of the most effective antidepressant, particularly for resistant depression, and also claimed to have additional therapeutic advantages. Both the drugs are known to have similar efficacy and few studies have been done in the Indian population to compare the cost-effectiveness and tolerability of these two drugs, hence the present study is taken up.

Objectives of the Study

   To evaluate the cost-effectiveness of escitalopram and desvenlafaxine in treatment of moderate to severe depression.

To assess the tolerability and QoL of escitalopram and desvenlafaxine in the study subjects