Abstract |
Pooled analysis of individual patient data was used to compare the antidepressant efficacy of agomelatine with that of selective serotonin reuptake inhibitors ( SSRIs) and serotonin and noradrenaline reuptake inhibitors ( SNRIs). We sought head-to-head, double-blind, randomized studies without a placebo arm using antidepressant doses in the licensed range and primary evaluation on the Hamilton scale (HAM-D(17)). Six studies were identified versus venlafaxine, sertraline, fluoxetine, paroxetine or escitalopram. Estimates of differences between treatments were calculated on parameters expressed as the last postbaseline value (6, 8 or 12 weeks). A total of 2034 patients were randomized (age 47.6 ± 14.9 years; 73% women; HAM-D(17) total score 26.9 ± 3.0). The full analysis set included 1997 patients (1001 agomelatine; 996 SSRI/ SNRI). There was a significant difference between HAM-D(17) total scores, with a greater reduction with agomelatine than with SSRI/ SNRI [E(SE), 0.86 (0.35), 95% confidence interval 0.18-1.53, P=0.013], and better rates of response on the HAM-D(17) (P=0.012) and the Clinical Global Impression-Improvement scales (P=0.032). Similar results were found in patients with severe depression. Agomelatine was associated with better tolerability than SSRI/ SNRI. Agomelatine has favourable efficacy and tolerability versus a range of SSRIs and SNRIs - including agents considered to have superior efficacy - and may deserve benefit-risk analysis as a first-line treatment of major depressive disorder.
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Authors | Siegfried Kasper, Emmanuelle Corruble, Anthony Hale, Patrick Lemoine, Stuart A Montgomery, Maria-Antonia Quera-Salva |
Journal | International clinical psychopharmacology
(Int Clin Psychopharmacol)
Vol. 28
Issue 1
Pg. 12-9
(Jan 2013)
ISSN: 1473-5857 [Electronic] England |
PMID | 23023074
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Chemical References |
- Acetamides
- Adrenergic Uptake Inhibitors
- Antidepressive Agents
- Serotonin Uptake Inhibitors
- agomelatine
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Topics |
- Acetamides
(adverse effects, therapeutic use)
- Adrenergic Uptake Inhibitors
(adverse effects, therapeutic use)
- Adult
- Antidepressive Agents
(adverse effects, therapeutic use)
- Depressive Disorder, Major
(diagnosis, drug therapy, psychology)
- Female
- Humans
- Male
- Middle Aged
- Randomized Controlled Trials as Topic
- Selective Serotonin Reuptake Inhibitors
(adverse effects, therapeutic use)
- Time Factors
- Treatment Outcome
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