SYNERGISTIC EFFECTS OF ESCITALOPRAM COMBINED WITH LEVOSULPRIDE AND ANTIOXIDANT VITAMINS ON ANTIOXIDANT ENZYME ACTIVITY IN PATIENTS WITH DEPRESSION: A COMPARATIVE CLINICAL STUDY.

JPUMHS; 2025:15:01, 25-32. http://doi.org/10.46536/jpumhs/2025/15.01.592

Abstract

ABSTRACT
BACKGROUND: Depression has been increasingly linked to oxidative stress, yet the
therapeutic role of antioxidants in conjunction with antidepressants remains underexplored. This
study investigates the effects of escitalopram alone and in combination with ascorbic acid,
vitamin E, and levosulpride on the activity of key antioxidant enzymes in patients diagnosed
with Major Depressive Disorder (MDD). METHODS: A total of 380 patients with MDD, aged
20–70, were recruited from the Baluchistan Institute of Psychiatry and Behavioural Sciences,
Quetta. Participants were randomized into four treatment groups: (1) Escitalopram only, (2)
Escitalopram + Vitamin C, (3) Escitalopram + Vitamin E, and (4) Escitalopram + Levosulpride.
After two months of treatment, serum levels of Superoxide Dismutase (SOD) and Glutathione
Peroxidase (GPx) were measured using colorimetric methods. RESULTS: The combination of
Escitalopram and Levosulpride significantly increased both SOD and GPx levels compared to
control (p < 0.05), suggesting a synergistic antioxidant effect. While vitamin C and E
combinations showed mild increases in enzyme levels, they were not statistically significant.
CONCLUSION: Escitalopram combined with Levosulpride may offer enhanced antioxidant
benefits in the management of depression by modulating oxidative stress pathways. These
findings support further exploration of combination therapies for personalized treatment
approaches in depressive disorders.