Journal Publication

Escitalopram edges vortioxetine on depression symptom relief at 4 weeks

A 100-patient randomized trial found escitalopram produced lower HAM-D depression scores than vortioxetine at week 4, a difference reaching statistical significance.

By AppliedXLJuly 15, 2026

Executive Summary

A randomized trial comparing two widely used antidepressants found one produced a faster reduction in depression symptom scores than the other over four weeks, with the difference reaching statistical significance.
The study set out to compare symptom reduction between the two drugs in adults with major depressive disorder, an area where head-to-head data have been limited despite both being commonly prescribed.
The open-label design, single-center setting, and short follow-up mean the result speaks to early symptom trajectory rather than sustained or cognitive outcomes.
The authors called for longer-term study to assess whether the early separation holds and whether cognitive benefits differ between the two drugs.

The comparison

Escitalopram, a selective serotonin reuptake inhibitor, and vortioxetine, a newer-generation antidepressant, are both routinely prescribed for major depressive disorder (MDD), but comparative data on their clinical and cognitive effects have been limited. The study set out to close part of that gap by measuring how quickly and how much each drug reduced depressive symptoms over a defined treatment window. Depression severity was tracked using the Hamilton Depression Rating Scale (HAM-D), a clinician-administered symptom scale, at baseline, two weeks, and four weeks. A

How it was done

This was a prospective, randomized, open-label trial (no blinding of treatment assignment) conducted at a single tertiary care center from October 2023 to October 2024. A total of 100 patients diagnosed with MDD were randomized to escitalopram 10 mg per day (n = 50) or vortioxetine 10 mg per day (n = 50). HAM-D scores were assessed at baseline, week 2, and week 4, with statistical significance evaluated using standard hypothesis tests. A

The result

Both drugs produced reductions in HAM-D scores across the four-week period. By week 4, escitalopram showed a lower mean HAM-D score than vortioxetine, 14.22 versus 16.32, a difference the study reported as statistically significant (P = 0.04). The authors described escitalopram as showing a more rapid onset of symptom relief over the same window. A

What it doesn't settle

The trial ran open-label at one center over four weeks, so the week 4 gap describes early symptom trajectory in this population rather than a blinded, multicenter, or longer-duration comparison. The authors noted that further long-term study is needed to assess sustained efficacy and cognitive benefits of both medications across more diverse patient populations. A

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