Evaluate the efficacy and tolerability of escitalopram and duloxetine in depressive patients with pain.

Sample A (escitalopram): 22 patients (15 female and 7 man, mean age 51.75); Sample B (duloxetine) 25 patients (18 female, 7 man, mean age 53,85). They were diagnosed with major depressive disorder according to ICD 10; assessed with HAMD 17 items in baseline, 14, 28, 42, 56 days; CGIS at baseline, 28 and 56 days; CGII at 28 and 56 days.

Escitalopram 10–20 mg/day; duloxetine 60–120 mg/day. Sample A HAMD 17 items: baseline-21.8; 14 days-19.7; 28 days- 17.2; 42 days-13.5; 56 days-11.8. Sample B HAMD 17 items: baseline-22.3; 14 days-19.9; 28 days- 17.4; 42 days-13.2; 56 days-10.5. Item 13(somatic/general) -diffuse or vague muscle aches or heaviness in the arms or legs mean baseline score for Sample A -1.65; Sample B-1.75; 56 days: Sample A-0.80 and Sample B-0.65. CGIS: mean baseline Sample A: 4.2 and Sample B-4.3; 56 days Sample A-1.9 and Sample B-1.5. CGII 56 days: Sample A 7/22 (31.8%) -much improved and 10/22(45.45%) very much improved; Sample B 11/25 (44%) much improved and 14.25(56%) very much improved. We noted mild nausea 20/47, mild restlessness 12/47, mild dizziness 9/47 at the beginning of the treatment (both samples).

1. 1) Escitalopram and duloxetine are safe and effective treatment.

2. 2) Coexistence of depression with physical pain negatively affects the performance in daily activity and quality of life; in such cases the first treatment option could be duloxetine.

3. 3) Escitalopram is also efficient in such cases.