JK SCIENCE Vol. 8 No. 4, October-December 2006 195 ORIGINAL ARTICLE From the Department of Pharmacology and *Psychiatry, Christian Medical College and Hospital, Ludhiana 141008 India. Correspondence to : Dr Dinesh K. Badyal, M.D., Reader, Department of Pharmacology, Christian Medical College, Ludhiana-141008 INDIA Introduction Major depressive disorder (MDD) continues to be a considerable problem, both for clinician and the public health level. It is currently the fourth leading cause of disease and disability worldwide and is projected to rise to second in 2020. Unfortunately many current therapies for depression provide remission in only approximately one third of patients (1). The current modalities of treatment of depression include tricyclic antidepressants (TCA), monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRI). TCA acts by inhibition of neuronal transport (reuptake) of norepinephrine (NE) and variable blockade of serotonin (5-HT) transport. TCAs are not preferred these days because of their adverse effect profile i.e. anticholinergic effects, cardiac arrhythmias and seizure precipitation. MAOIs are used in refractory cases because of their interactions with foods. SSRIs are presently the most widely used antidepressants because of their better safety profile and tolerability. SSRIs selectively block neuronal transport of serotonin and increase synaptic availability of serotonin (2). It has been suggested that dual inhibition of monoamine reuptake process may offer advantage over other Safety and Efficacy of Duloxetine Versus Venlafaxine in Major Depression in Indian Patients Dinesh K. Badyal, Prem P. Khosla, Rajinder S. Deswal,* Prithpal S. Matreja Abstract The objective of the study was to compare the efficacy and safety of duloxetine and venlafaxine in major depressive disorder. The study was conducted in 26 patients suffering from major depressive disorder as per DSM-IV criteria. Patients were randomized to two groups and were given duloxetine (20,40,60mg BD) and venlafaxine (75,150,225mg OD) for 6 weeks. The primary efficacy parameter was the Hamilton Depression Rating Scale (HDRS-17). Secondary efficacy parameters included the Montgomery and Asberg depression rating scale (MADRS) and clinical global impression (CGI) scale. Safety evaluation was based on treatment emergent adverse effects and laboratory investigations. There was significant decrease in HDRS, MADRS, CGI scores from baseline to endpoint (p<0.05) in both the groups. However the difference in scores between two groups was not statistically significant. Total mean HDRS score decreased from 27(SD=2.5) to 4 (SD=1.2) in duloxetine group and from 29(SD=2.3) to 4 (SD=1.0) in venlafaxine group at the end of therapy. Response and remission rate was 96% and 69% in duloxetine group as compared to 92% and 62% in venlafaxine group respectively. There was no significant difference in adverse effects and laboratory investigation in two groups. The findings of this study indicate that duloxetine may be an effective and safe antidepressant in Indian patients of major depressive disorder. It is equally effective to venlafaxine in patients of depression. Key Words Duloxetine, Venlafaxine, Depression