Dealing with depression in end stage renal disease,Escitalopram vs Nortryptyline

Background: there is lack of consensus on the choice of anti-depressant for treatment of highly prevalent depression in patients with end stage renal disease. aim: to compare the efficacy and safety selective serotonin reuptake inhibitor with a tricyclic antidepressant in esrd patients method: a total of 30 end stage renal disease patients were recruited in the study suffering from depression. they were further divided into two groups having 15 patient each. first group (group a) received escitalopram (ssri) and the second group (group b) received nortryptyline (tca). the hamilton rating scale (ham-d) for depression was used to assess the change in depression severity. results: group a (n=14) showed a reduction in ham-d scores from a mean of 23.6+6.9 to 10.4+3.2 (p=0.003),whereas,group b (n=13) showed a reduction in ham-d scores from a mean of 19.4+4.2 to 7.6+4.2 (p=0.002). the mean asec score of group a was 5.67 and 7.86 for group b. conclusion: the efficacy of both escitalopram (ssri) and nortriptyline (tca) was comparable to each other with no drug standing out as having significant superiority over the other. however,both the drugs used in the trial established efficacy in depression treatment by showing statistically significant reduction ham-d scores. the safety of both the drugs was also comparable and no drug stood out as significantly safer than the other.