Comparative Efficacy and Safety of Augmentation Therapy with Ziprasidone versus Quetiapine in Patients of Major Depressive Disorder on Escitalopram

Many patients with major depressive disorder (MDD) do not improve or partially respond to conventional antidepressant therapy. Therefore, augmentation therapy is required in many patients with atypical antipsychotic agents, enhancing the antidepressant action and building on partial remission. This study was carried out to compare augmentation therapy by ziprasidone & quetiapine with escitalopram in patients with MDD. The study was a prospective, open-label, randomized, comparative clinical study. Adult patients who met the criteria for MDD as defined by DSM-5, and HAM-D score of 15 or more on the 17 item version, were included in Part-I of the Study. MDD with psychotic features and bipolar disorder were the critical exclusion criteria. At the end of 6 weeks of treatment with escitalopram (20 mg per day), the eligible patients, showing inadequate response to treatment (Part-II of Study), were randomly allocated to 2 treatment groups; augmentation with quetiapine 200 mg once daily or ziprasidone 20 mg twice daily orally for 6 weeks. Efficacy was during the clinical study was assessed using BDI scores at 2, 4, and 6 weeks. Adverse drug reactions (ADRs) in the two groups were of mild grade, and none of the study participants warranted discontinuation of treatment. In this study, the augmentation of antidepressant therapy with quetiapine and ziprasidone was safe and effective.