Expert Opinion on the Prescription Practice of Selective Serotonin Reuptake Inhibitors for Major Depressive Disorder in Indian Settings

Objective: To gather expert opinions and insights on the prevalence of anxiety and depression, along with prescription trends for different therapeutic options based on escitalopram, in Indian outpatient settings. Methodology: The questionnaire-based survey, comprising 28 questions, collected perspectives of experts across India regarding the prescription practice of selective serotonin reuptake inhibitors (SSRIs) with a special focus on escitalopram for treating major depressive disorder. Additionally, information on the symptoms of major depressive disorder and the age range of those affected by the disorder was also collected. Results: About 53% of the 331 participants reported that behavioral symptoms were the most frequent among depressed patients. Among the various classes of antidepressants, about 86% of the participants indicated SSRIs as their preferred choice for treating depression. In comparison to vilazodone, paroxetine, and sertraline medications, approximately 87% of the respondents favored escitalopram as the ideal option for treating depression. According to 64% of the respondents, the use of escitalopram has led to improvements in 50-75% of patients. Around 74% of the respondents reported a significant correlation between early responders to antidepressant therapies and achieving full remission. About 49% stated that it may take 8 weeks for depressive patients undergoing escitalopram therapy to experience remission. Adverse effects and poor response were highlighted as the reasons for depressive patients transitioning from other SSRI medications to escitalopram by approximately 43% of the respondents. Conclusion: The survey emphasizes the significance of the 8-week regimen of escitalopram in achieving full remission in patients with depression. The majority of respondents underscored the superiority of escitalopram among SSRIs when compared to other options like vilazodone, paroxetine, and sertraline, reaffirming its role as a preferred choice for effective depression treatment.