Comparative study of efficacy of amitriptyline and fluoxetine in patients presenting with mixed anxiety and depression

Abstract

Aim: To analyse the comparative study of efficacy and tolerability of amitriptyline and fluoxetine in patients presenting with Mixed-Anxiety and Depression. Introduction: Mixed anxiety and depression is a condition where both the symptoms of anxiety and depression are present. Globally, depression is the top cause of illness and disability among young and middle-aged populations, while suicide ranks second among causes of death for the same age groups. Depression increase the mrotality because it worsens many medical conditions such as cardiovascular disease and diabetes and increase risk of suicide. Methodology: A prospective observational study was conducted for a period of 6 months in OPD of Jayanagar General Hospital, Bengaluru and BBMP Public health camps. Patient aged between 19-59 years with mixed anxiety and depression (as defined by ICD 10) were equally divided randomly in fluoxetine and amitriptyline groups. Patients assessment was done at 1st visit, 2nd week, 4th week and 8th week for efficacy and safety parameters such as HAM-A and HAM-D. Student t-test was performed on efficacy measure. Results: In the total of 62 patients, 25 (40.32%) were male and 37 (59.68%) were female. On HAM-A the percentage improvement (reduction in the mean score) for fluoxetine group was and 92.37%, while that for the amitriptyline group was 89.21% on 8th week. HAM-D the percentage improvement (reduction in the mean score) for fluoxetine group was 92.34%, while in amitriptyline group 89.29% on 8th week. Conclusion: Our study shows Fluoxetine apparently working faster than Amitriptyline. Fluoxetine being an SSRI claimed to be equally effective as TCA in treating Mixed Anxiety and Depression with least adverse effects and better tolerability.