Comparative effectiveness of Vortioxetine and Paroxetine in peri menopausal and post menopausal depression

After obtaining ethical and CTRI approval, 66 women diagnosed with depressive disorders as per ICD 11 and identified as perimenopausal or postmenopausal will be recruited from the Psychiatry and Obstetrics and Gynaecology outpatient departments of GMCH 32 Chandigarh. Participants meeting inclusion criteria and providing written informed consent will be randomly assigned to two groups using a computer generated random number table: Group A Vortioxetine and Group B Paroxetine. Baseline assessments will include sociodemographic and clinical profiles, depression (HDRS 17), anxiety (HAM A), quality of life (WHOQOL BREF Hindi), menopausal symptoms (Menopause Rating Scale), and cognitive functioning (MoCA Hindi, DSST, TMT, Digit Span Test), along with physical and laboratory evaluations.Vortioxetine will be initiated at 10 mg per day adjustable 5 to 20 mg per day and Paroxetine at 12.5 mg per day adjustable 12.5 to 37.5 mg per day based on response on HDRS 17. Patients will be followed up at 2, 4, 6, and 10 weeks to assess clinical improvement, cognitive function, and side effects. Final evaluations, including laboratory and neurocognitive assessments, will be conducted at 10 weeks. A reduction of 50 percent or more in HDRS 17 score from baseline will define treatment response. Participants developing intolerable side effects, becoming UPT positive, or withdrawing consent will be dropped and managed as per protocol.