Agomelatine in the treatment of seasonal affective disorder
The novel antidepressant agomelatine acts as a melatonergic (MT1 and MT2) receptor agonist and as a serotonin-2C receptor antagonist. Previous studies showed that agomelatine is able to restore disrupted circadian rhythms, which were implicated in the pathophysiology of seasonal affective disorder (SAD).
The aim of this study was to investigate the efficacy and tolerability of agomelatine in the treatment of SAD.
Materials and methods
Thirty-seven acutely depressed SAD patients were included in an open study with agomelatine (25 mg/day in the evening) over 14 weeks. Efficacy assessments included the Structured Interview Guide for the Hamilton Depression Rating Scale (SAD version; SIGH-SAD), the Clinical Global Impression of Severity (CGI-S) and Improvement (CGI-I), the Circscreen, a self-rating scale for the assessment of sleep and circadian rhythm disorders, and the Hypomania Scale.
Agomelatine led to a progressive and statistically significant decrease of SIGH-SAD, CGI-S, and CGI-I scores from week 2 onward (p < 0.001). Furthermore, scores on the Circscreen improved significantly during the study (p < 0.001). Treatment with agomelatine over 14 weeks yielded a response rate of 75.7% (SIGH-SAD <50% of baseline value) and a remission rate (SIGH-SAD <8) of 70.3% in the intention to treat sample. Scores on the Hypomania Scale were consistently low during the study. Agomelatine showed good overall tolerability: throughout the study only one adverse event (mild fatigue) was related to the study drug.
The results of this study suggest that seasonal depression may be effectively and safely treated with agomelatine.
KeywordsDepression Seasonal affective disorder SAD Agomelatine Antidepressant Pharmacotherapy
This study was supported by a grant from Servier. The authors thank Mrs. Brigitta Kusternig (Department of General Psychiatry, Medical University of Vienna) for her dedicated support during the course of this study.
Statement of interest
Prof. Kasper has received research grants, consultancy fees, and lecture fees from a number of pharmaceutical companies in the area of CNS development. The authors of this study were supported by various travel grants.
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