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Escitalopram Application in Patients with MDD- Real-world Assessment in Indian Patients

BASIC DETAILS

Patient code (Do not write name here) *

Date *

Diagnosis : MDD (As per DSM-5 criteria)

Patient's Age (years) *

Gender *

Male Female

Socioeconomic Status *

Upper Middle Poor

Duration of MDD *

Months

Previous Antidepressant *

Yes No

Concomitant Medical Conditions *

Hypertension Diabetes Sleep disorders Thyroid disease Cardiovascular disease Other

Escitalopram Dosage *

mg/day

Duration of Escitalopram *

4-8 weeks 8-12 weeks 12-24 weeks >24 weeks

Concomitant Medications: (as applicable)

Baseline MADRS Score *

Week 8 MADRS Score *

Response to Treatment (>50% Score Reduction) *

Yes No

Remission Achieved (MADRS <10) *

Yes No

Have you observed any other adverse drug reactions with usage of drug *

Yes No

Severity *

Mild Moderate Severe

Adherence to Escitalopram *

High (>80% adherence) Moderate (50-79%) Low (<50%)

Reason for Non- Adherence (if applicable)

Side Effects Cost Patient Preference Other

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