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Comparison of agomelatine and escitalopram on nighttime sleep and daytime condition and efficacy in major depressive disorder patients.

Abstract
Agomelatine, an MT1/MT2 receptor agonist and 5-HT2C receptor antagonist antidepressant, is known to have beneficial effects on subjective sleep in major depressive disorder patients. This international multicenter, randomized, double-blind study compared the effects of agomelatine (25-50 mg/day) and escitalopram (10-20 mg/day) on sleep polysomnographic parameters in major depressive disorder patients treated up to 24 weeks. A total of 138 outpatients were randomly allocated to agomelatine (n=71) or escitalopram (n=67). Treatment with agomelatine was associated with a reduction in sleep latency from week 2 onward. The difference between treatments was significant on all evaluations. Rapid eye movement latency was increased with escitalopram compared with agomelatine, with significant between-group differences at every visit. Agomelatine preserved the number of sleep cycles, whereas it was decreased with escitalopram with significant between-group differences at every visit. Assessments on visual analogue scales indicated that treatment with agomelatine improved morning condition, and reduced daytime sleepiness compared with escitalopram.17-item Hamilton depression rating scale total score was reduced in both groups, agomelatine was statistically noninferior to escitalopram at 6 weeks. Both treatments were well tolerated. This study showed that the clinical effects of agomelatine on sleep and wake parameters are different from that of escitalopram.
AuthorsMaria-Antonia Quera-Salva, Goeran Hajak, Pierre Philip, Jaques Montplaisir, Sophie Keufer-Le Gall, Judith Laredo, Christian Guilleminault
JournalInternational clinical psychopharmacology (Int Clin Psychopharmacol) Vol. 26 Issue 5 Pg. 252-62 (Sep 2011) ISSN: 1473-5857 [Electronic] England
PMID21829106 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Acetamides
  • Hypnotics and Sedatives
  • Serotonin Uptake Inhibitors
  • Citalopram
  • agomelatine
  • Melatonin
Topics
  • Acetamides (pharmacology, therapeutic use)
  • Adult
  • Citalopram (pharmacology, therapeutic use)
  • Depressive Disorder, Major (drug therapy, psychology)
  • Double-Blind Method
  • Female
  • Humans
  • Hypnotics and Sedatives (therapeutic use)
  • Male
  • Melatonin (agonists)
  • Middle Aged
  • Polysomnography (methods)
  • Selective Serotonin Reuptake Inhibitors (therapeutic use)
  • Sleep Stages (drug effects, physiology)
  • Treatment Outcome
  • Wakefulness (drug effects, physiology)

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