Agomelatine versus Sertraline: An Observational, Open-labeled and 12 Weeks Follow-up Study on Efficacy and Tolerability

Abstract

ObjectiveIn this open-labeled, 12 weeks follow-up study, we aimed to compare the efficacy and tolerability of agomelatine with sertralineMethodsThe outpatients of adult psychiatry clinic who have a new onset of depression and diagnosed as ‘major depressive episode’ by clinician according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition and prescribed agomelatine (25 mg/day) or sertraline (50 mg/day) were included in the study.ResultsThe decline of mean Montgomery-Asberg Depression Rating Scale (MADRS) scores of agomelatine group was significantly higher than the sertraline group at the end of 2nd week; however, the difference was not significant at the end of 3 months. Mean Clinical Global Impression-Improvement scale (CGI-I) scores of agomelatine group was lower than sertraline group at first week. Mean CGI-Severity scale and CGI-I scores were favour to sertraline group at the end of the study. Remission rates were 46.7% for sertraline group and 33.3% for agomelatine group while response rates were 76.7% for both groups. Any patient from agomelatine group dropped-out due to adverse effects. The amount of side effects was also less with agomelatine.ConclusionAgomelatine has a rapid onset efficacy on depressive symptoms and this can be beneficial for some critical cases. Considering MADRS scores, agomelatine seems to have similar efficacy with sertraline but we also point the need for long term studies since CGI scores were favour to sertraline group at the end of the study. Agomelatine has a favourable tolerability profile both in terms of discontinuation and the amount of side effects compared to sertraline.

Comparison of the effects of sertraline and agomelatine on sleep quality, sexual functioning and metabolic parameters in patients with major depressive disorder

“…This study is a part of a comprehensive project to assess the efficacy and tolerability profiles of agomelatine and sertraline, the first article of which was published in 2016 [5] and included an efficacy and general tolerability profile. More specific issues related to drugs and their effect on sleep, sexuality, and metabolic parameters are covered in the present study.…”

“…Comparative studies of agomelatine with selective serotonin re-uptake inhibitors (SSRIs) or serotoninnoradrenaline re-uptake inhibitors (SNRIs) have demonstrated that agomelatine has a favourable tolerability profile [4][5][6]. Discontinuations due to adverse effects have been found to be fewer in patients using agomelatine when compared to SSRI or SNRIs [7,8].…”

The Neuroprotective Effects of Melatonin: Possible Role in the Pathophysiology of Neuropsychiatric Disease

“…Reportedly, circadian rhythm and melatonin may be associated with depression [73,74]. Agomelatine, a MT1 and MT2 receptor agonist, is the first melatonin receptor ligand to demonstrate antidepressant effects in animal model experiments [75,76]. In a study with Flinders Sensitive Line rats, Overstreet et al showed that agomelatine reduced immobility time in the forced swim test (FST) [77].…”

The Effects of Fluoxetine and Agomelatine on Neurocognitive Functions and Sleep in Patients with Major Depressive Disorder

“… 28 In an open-label, observational follow-up study, agomelatine’s efficacy was not significantly different from sertraline. 29 A pooled analysis of 4 follow-up clinical trials revealed that agomelatine is at least as efficacious as escitalopram, fluoxetine, and sertraline. 30 In addition, a meta-analysis revealed that agomelatine had similar efficacy with standard antidepressants.…”