Comparison of Tianeptine Versus Escitalopram Patients Major Depressive Disorder

Inclusion Criteria:

1. Patients fulfilling DSM-IV-TR(American Psychiatric Association, 4thedition, 2000)criteria for Major Depressive Disorder diagnosis

2. The male or female patients aged more than 40 years

3. Patients able to hand in written informed consent before his/her participation in thisclinical study

4. Women of childbearing potential with negative pregnancy test during screening phaseand entire study period (during entire study period, able to clearly agree witheffective contraception such as contraceptive pill, progesterone injection,levonorgestrel implant, estrogen ring, transdermal contraceptive agent, intra-uterinecontraceptive device, sterilization operation of husband, and double contraceptivemethod (e.g. combination of condom, pessary, spermicide, etc. ))

5. Patients who have subjective cognitive impairment, or who have objective cognitiveimpairment (MMSE ≤26) without subjective cognitive impairment

6. HAM-D(17-items) total score ≥ 16

Exclusion Criteria:

1. Patients meeting more than one following patient characteristics

2. Patients fulfilling DSM-IV-TR current or past diagnosis of any psychiatricdisorders other than major depressive disorder (i.e. manic or hypomanic episode,schizophrenia, delirium, dementia, eating disorder, obsessive-compulsivedisorder, panic disorder, post-traumatic stress disorder, major depressivedisorder with psychotic features, mental retardation, organic brain disorder, orpsychiatric disorders due to general medical condition, according to DSM-IV-TR)

3. Patients with any substance-related disorder (excluding nicotine) within the past 12 months, as defined in DSM-IV-TR

4. Patients with a history or presence of any neurological disorders (e.g. multiplesclerosis, seizure, etc.)

5. Patients with any axis II disorder that prone to interfere with the evaluation ofthe study

6. Patients with a history or presence of any hypersensitivity to tianeptine,escitalopram or other drugs

7. Patients who receive formal psychotherapy (e.g. cognitive behavioral therapy,insight-oriented psychoanalysis, interpersonal therapy, etc.) and who have a plan forgetting psychotherapy

8. Patients with any clinically significant abnormality (e.g. hepatic failure, renalfailure, cardiovascular disorder, respiratory disorder, gastrointestinal disorder,endocrine disorder, neurological disorder, inflammatory disorder, neoplasm, metabolicdisorder, etc.)

9. Patients who have abnormal ECG and a significant disease according to theinvestigator's judgment

10. Patients with any chronic liver or kidney disease

11. Patients with a family history of long QT syndrome

12. Patients previously not responders to tianeptine or escitalopram in the treatment ofmajor depressive disorder

13. Patients who have a suicide risk according to the investigator's judgment