title: A naturalistic evaluation and audit database of agomelatine: clinical outcome at 12 weeks.
abstract: OBJECTIVE
  To determine the effectiveness of agomelatine in routine clinical practice and explore factors associated with response and continuation.
  
  
  METHODS
  Consecutive patients prescribed agomelatine in participating psychiatric services were included. Patient demographic and outcome data were collected at treatment initiation and then at weeks 4, 8 and 12. Outcomes were analysed with respect to clinical and demographic factors.
  
  
  RESULTS
  A total of 110 patients from nine NHS trusts were followed through 12 weeks of treatment. Agomelatine was largely used in difficult-to-treat or refractory patients: 83 (75%) had failed to respond to, or relapsed on, prior antidepressants. There were high rates of physical (54.5%) and psychiatric (50.0%) comorbidity. At 12 weeks of treatment, 68 (62%) continued agomelatine treatment. Overall, 69 subjects (62.7%) improved by at least one point of the Clinical Global Impression (severity) scale. Of 42 who discontinued, 23 (56%) discontinued because of lack of efficacy and 10 (24%) due to an adverse event. Of all variables examined, only a history of more than five episodes of depression significantly predicted discontinuation of treatment (OR continuation - 0.36, 95% CI 0.14, 0.95).
  
  
  CONCLUSIONS
  Agomelatine was effective and generally well tolerated in a cohort of difficult-to-treat patients in clinical practice.
authors.affiliation: Pharmacy Department, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sparshatt
authors.forename: R H
authors.initials: RH
authors.lastname: McAllister Williams
authors.forename: D S
authors.initials: DS
authors.lastname: Baldwin
authors.forename: P M
authors.initials: PM
authors.lastname: Haddad
authors.forename: S
authors.initials: S
authors.lastname: Bazire
authors.forename: E
authors.initials: E
authors.lastname: Weston
authors.forename: P
authors.initials: P
authors.lastname: Taylor
authors.forename: D
authors.initials: D
authors.lastname: Taylor
mesh_terms: D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D006113:United Kingdom; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D006993:Hypnotics and Sedatives; C084711:agomelatine; D009281:Naphthalenes