title: 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.
authors.affiliation: AP-HP Sleep Unit, Department of Physiology, Raymond Poincaré Hospital, Garches, France. ma.quera@rpc.aphp.fr
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Quera-Salva
authors.forename: Goeran
authors.initials: G
authors.lastname: Hajak
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
authors.forename: Jaques
authors.initials: J
authors.lastname: Montplaisir
authors.forename: Sophie
authors.initials: S
authors.lastname: Keufer-Le Gall
authors.forename: Judith
authors.initials: J
authors.lastname: Laredo
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008550:Melatonin / Q000819:agonists; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012894:Sleep Stages / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome; D014851:Wakefulness / Q000187:drug effects* / Q000502:physiology; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D015283:Citalopram; D006993:Hypnotics and Sedatives; D008550:Melatonin; D017367:Selective Serotonin Reuptake Inhibitors; C084711:agomelatine; D009281:Naphthalenes