A randomized open-label study to evaluate the effects of escitalopram and mirtazapine on psychomotor functions and memory in patients with depression

Abstract

Objective: To compare the effects of escitalopram and mirtazapine on psychomotor functions and memory and also to correlate the antidepressant efficacy of these drugs with psychomotor functions. Materials and Methods: This study was carried out at a tertiary care teaching hospital on 104 newly diagnosed literate patients with endogenous depression as per the inclusion and exclusion criteria. Patients were prescribed either escitalopram (20 mg OD) or mirtazapine (15 mg OD) or amitriptyline (75 mg BD). Psychomotor functions were assessed by digit-letter substitution, six-letter cancellation, choice reaction time, hand steadiness, and flicker fusion tests, and memory was assessed by PGI memory scale at the baseline and at the end of the 1 st week, 1 st month, and 4 th month. Efficacy of drugs was measured by the Hamilton Depression Rating Scale (HDRS) at the baseline and each follow-up. The antidepressant efficacy of these drugs with various psychomotor function tests was correlated using Pearson's correlation test. P < 0.05 was considered statistically significant. Results: A total 95 patients, 32 in escitalopram, 32 in mirtazapine, and 31 in amitriptyline group, completed the study. Escitalopram and mirtazapine improved all psychomotor functions while amitriptyline significantly deteriorated (P < 0.001). All three drugs were equally efficacious (P > 0.05). A strong correlation was observed between psychomotor functions and HDRS score in patients treated with escitalopram (positive correlation), mirtazapine (positive correlation), and amitriptyline (negative correlation). Conclusion: Escitalopram and mirtazapine improve psychomotor function in patients with endogenous depression while amitriptyline deteriorates it. Thus, escitalopram and mirtazapine may be preferred to amitriptyline in clinical practice.