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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.