Agomelatine Versus Venlafaxine XR in the Treatment of Anhedonia in Major Depressive Disorder

Abstract

The primary aim of the present study was to compare the effects of agomelatine (AGO) and venlafaxine XR (VLX) on anhedonia in patients with major depressive disorder. Secondary end points were to test its antidepressant and anxiolytic efficacy.Sixty patients were enrolled and randomly assigned to two different treatments: AGO (25-50 mg/d; n = 30 subjects) or VLX (75-150 mg/d, n = 30 subjects). Psychopathological assessment was performed at baseline and after 8 weeks of treatment with the Snaith Hamilton Rating Scale (SHAPS), the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Clinical Global Impression for anhedonia, depression, anxiety, and global improvement, respectively.Both groups showed a significant reduction in time for the SHAPS, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. A significant between-group difference was observed for SHAPS scores: patients treated with AGO showed a more relevant reduction compared with that in VLX-treated patients. Moreover, only patients treated with AGO showed a statistically significant improvement in Clinical Global Impression scores.In this study, AGO showed significantly greater efficacy on anhedonia and similar antidepressant efficacy to the serotonin-norepinephrine reuptake inhibitor VLX in patients with major depressive disorder during an 8-week treatment period. Anhedonia has been considered a potential trait marker related to vulnerability for depression. Therefore, the efficacy of AGO on this dimension holds particular importance in the treatment of patients with anhedonic features.

Mouse psychosocial stress reduces motivation and cognitive function in operant reward tests: A model for reward pathology with effects of agomelatine

“…In clinical trials, therapeutic efficacy of AGO is increased relative to placebo in moderate to severe depression (Kennedy et al, 2014). When the core symptom/domain of interest-pleasure was measured using a self-report questionnaire, in depressed patients efficacy of AGO on anhedonia was increased relative to venlafaxine Martinotti et al, 2012). In terms of operant tests of reward processing, whilst there are no published studies with AGO to-date, a 5-HT 2C antagonist compound was demonstrated to improve reversal learning, in part by decreasing perseveration, in a rat model (Boulougouris et al, 2008).…”

Is There a Role for Agomelatine in the Treatment of Anxiety Disorders? A Review of Published Data

“…The circadian pacemaker or biological clock, located in the suprachiasmatic nuclei (SCN) of the anterior hypothalamus, above the optic chiasma, is the site of generation of circadian rhythms and prepares the organism to anticipate the daily changes in the environment (6). The activation ofmelatonergic MTl receptors directly inhibits firing of neurons in the SCN, thus regulating the amplitude of the circadian rhythmicity, and facilitating sleep promotion, whereas melatonin-mediated activation of MT2 receptors is responsible for inducing phase shifts and, therefore, may be involved in the entrainment of circadian rhythmicity (7)(8)(9).…”

Clinical and therapeutic perspectives of agomelatine (valdoxan) in the treatment of anhedonia in patients with endogenous depressions

“…1, 2, 3, 9), социальной активности (п.п. 7,8,13,14), эмоциональной вовлеченности (п.п. 5,6,11,12) и еды/питья (п.п.…”

“…В сравнительных исследованиях [6,7] было показано, что агомелатин в дозе 25-50 мг в сутки более эффективен в отношении симптомов ангедонии, чем венлафаксин.…”