Which Antidepressants Are Best Tolerated in Primary Care? a Pilot Randomized Trial from Goa

Even though cultural, biological and health service factors influence the tolerance and acceptability of psychotropic drugs in different settings, there is a lack of data on the use of antidepressants in primary care settings from India. The aim of this study was to examine the tolerance of 3 models of antidepressants treatments (fluoxetine 20 mg; imipramine 75 mg; imipramine 150 mg) for common mental disorders in attenders at a primary care clinic in Goa. The study design was a randomized trial. A total of 61 adult subjects with a common mental disorder were recruited and randomized to one of the 3 groups. Subjects were reviewed at 2 and 6 weeks. The main outcome measures were discontinuation rates. The key findings are that while discontinuation rates are higher in subjects on imipramine 150 mg as compared to the other groups, the majority of subjects in all groups discontinued their medication. The commonest reasons for discontinuation are anticholingeric and hypotensive side effects.