title: Efficacy of the novel antidepressant agomelatine for anxiety symptoms in major depression.
abstract: OBJECTIVE
  Anxiety in major depression is associated with increased morbidity. The antidepressant, agomelatine, which acts as an agonist at melatonin MT(1) and MT(2) receptors and as an antagonist at serotonin 5-HT(2C) receptors, has demonstrated efficacy and safety in both major depression and generalized anxiety disorder. Here, we investigated the efficacy of agomelatine in anxious depression.
  
  
  METHODS
  Data from three placebo-controlled short-term trials of agomelatine and three comparative studies of agomelatine versus fluoxetine, sertraline, and venlafaxine were pooled. Effects of agomelatine on anxiety symptoms were assessed with the Hamilton Anxiety Rating Scale in four studies (one vs placebo and three vs active comparator) and with the Hamilton Depression Rating Scale (HAMD) anxiety subscore in all six studies. Anxiolytic and antidepressant efficacies of agomelatine were assessed in patients with more severe anxiety symptoms at baseline (score ≥5 on HAMD anxiety subscore).
  
  
  RESULTS
  Agomelatine had a significantly greater effect on anxiety symptoms than both placebo and a number of comparator antidepressants. In more anxious depressed patients, agomelatine had a significantly greater effect on anxiety and depressive symptoms than both placebo and comparator antidepressants.
  
  
  CONCLUSIONS
  Once-a-day oral agomelatine is a new, efficacious alternative option for the treatment of anxiety in patients with major depression.
authors.affiliation: Department of Psychiatry, University of Cape Town, South Africa. dan.stein@uct.ac.za
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Francoise
authors.initials: F
authors.lastname: Picarel-Blanchot
authors.forename: Sidney H
authors.initials: SH
authors.lastname: Kennedy
mesh_terms: D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000819:agonists; D008875:Middle Aged; D016896:Treatment Outcome; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D000928:Antidepressive Agents; D008550:Melatonin; C084711:agomelatine; D009281:Naphthalenes