Agomelatine in treating generalized anxiety disorder.
BACKGROUND
Generalized anxiety disorder (GAD) is a chronic and disabling disorder with a lifetime prevalence of 4.3 - 5.9% in the general population. Many drug and non-drug treatments have been shown to be effective in the treatment of GAD, including benzodiazepines, antidepressants (selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors and tricyclic antidepressants), anticonvulsants, azapirones, antihistamines, atypical antipsychotics, complementary/alternative medicine, psychotherapy and Internet-based services. Agomelatine is an antidepressant approved by the European Agency; it is a melatonergic agonist (MT1 and MT2 receptors) and a 5-HT2C antagonist indicated in the treatment of major depressive episodes.


METHODS
The present article looks at the short-term efficacy of Agomelatine assessed in two short-term placebo-controlled studies. It also looks at the long-term efficacy evaluated in one relapse prevention study.


CONCLUSIONS
Agomelatine is an effective treatment option for both GAD and somatic anxiety. The trial, which includes an escitalopram arm, shows comparable efficacy in GAD between both antidepressants, whereas the restoration of sleep was significantly better with agomelatine. The low discontinuation rate illustrates the good tolerability and lab results show a low incidence of transient elevations in liver enzymes. Whereas uptitrated patients on a 50 mg dose have a lower chance of reaching the desired outcome than the lower 25 mg dose, those reaching this outcome have a better chance of treatment continuation.
University Psychiatric Center KU Leuven, campus Gasthuisberg , Herestraat 49, 3000 Leuven , Belgium koen.demyttenaere@med.kuleuven.be.
Koen
K
Demyttenaere
D000081:Acetamides / Q000627:therapeutic use*; D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D012890:Sleep / Q000187:drug effects; D016896:Treatment Outcome; D009281:Naphthalenes
D000081:Acetamides; D000928:Antidepressive Agents; C084711:agomelatine; D009281:Naphthalenes
agomelatine; generalized anxiety disorder