Abstract
Background: Depression is a frequently occurring mental health problem that affects people from all walks of life. Similar emphasis is placed on physical and mental wellness. Anxiety is frequently present along with depression when it has a chronic course. In comparison to depression alone, anxiety-associated depression may be more severe, has a higher propensity for suicide, and has an inadequate treatment response. Serotonin-norepinephrine reuptake inhibitors (SNRI) and selective serotonin reuptake inhibitors (SSRI) are said to be more successful in treating anxiety-associated major depressive disorder (MDD).

Aims and Objectives: MDD with anxiety is effectively treated with SSRI and SNRI. Desvenlafaxine (SNRI) and escitalopram (SSRI) were compared for safety and effectiveness in this randomized, open-label trial.

Materials and Methods: With prior approval from the institutional ethical committee, 100 patients with the diagnoses of depression and anxiety were enrolled in the study. The patients were split into two groups at random at a ratio of 1:1. Desvenlafaxine was administered to the test group, whereas escitalopram was administered to the control group as the standard medication. Both medications were administered orally once each day for a total of 8 weeks. At the beginning, 4th, and 8th weeks, the patients were observed. Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A) assessments of effectiveness were compared. During follow-up visits, patients who experienced a reduction in rating scores of at least 50% from baseline were considered treatment responders. Alterations in laboratory measurements, vitals, and reported side effects were used to evaluate safety and tolerability.

Results: The HAM-D and HAM-A scores in both the desvenlafaxine and escitalopram groups significantly decreased from their respective baselines (P < 0.001). At 4 and 8 weeks of treatment, however, neither group was able to demonstrate a statistically significant difference. Both escitalopram and desvenlafaxine were determined to be safe, with escitalopram having superior tolerance and much fewer adverse effects recorded than desvenlafaxine.

Conclusion: Escitalopram and desvenlafaxine were equally effective at reducing the symptoms of anxiety related depression. Escitalopram was found to be well tolerated.