Posted by desolationrower on September 2, 2008, at 23:39:33
In reply to Re: Setp 2: Agomelatine SUPERIOR to Zoloft » Phillipa, posted by desolationrower on September 2, 2008, at 23:00:35
From the same announcement
Comparative efficacy of the antidepressants agomelatine, venlafaxine and sertraline print the Paper
Citation: European Neuropsychopharmacology The Journal of the European College of Neuropsychopharmacology, Volume 18 Supplement 4, Page S331
S. Kasper1, P. Lemoine2
1Medical University of Vienna, Department of General Psychiatry, Vienna, Austria
2Clinique Lyon Lumiere, Biological psychiatry, Lyon Bron, FranceBackground: Agomelatine is an novel antidepressant agent with a receptoral profile different from antidepressants currently in clinical use. Agomelatine is a potent agonist at melatonergic MT1 and MT2 receptors and an antagonist at 5HT2c receptors [1]. Clinical studies have demonstrated its efficacy for the treatment of major depressive disorder [2]. As statistical significance and clinical effectiveness are not synonymous, antidepressants need to demonstrate their ability to alleviate patients' symptoms in clinical practice. Furthermore, even in the case of good short-term efficiency, a valuable antidepressant needs to demonstrate its properties over long-term treatment. Moreover, to be useful in clinical practice, a new antidepressant needs to provide advantages in comparison with other drugs already commonly prescribed.
Purpose: To evaluate the clinical efficacy of agomelatine in comparison with venlafaxine and sertraline in clinical practice, for short-term and long-term symptom alleviation.
Methods: Two studies were selected: one comparing agomelatine (2550 mg/d,) with venlafaxine (75150 mg/d) [3], and a second comparing agomelatine (2550 mg/d,) with sertraline (50100 mg/d). In the first study, 165 patients were randomized to receive agomelatine and 167 to receive venlafaxine. In the second study, 154 patients were randomized to receive agomelatine and 159 to receive sertraline. Both studies were multicenter and conducted in double-blind. Treatment was for 6 weeks with an optional extension period of 6 months.
The results considered were those obtained from the Clinical Global Impression (CGI) rating scale, a scale developed to assess treatment response in mental disorders. It contains items such as severity of the Illness (CGI-S) and global improvement (CGI-I). The CGI scale is easy to use for clinicians and directly reflects their clinical impression.
Results: Compared with venlafaxine, the clinical superiority of agomelatine appeared as early as week one (two tailed superiority test; P < 0.0001) the mean difference in between the two treatments being 0.39. This superiority of agomelatine was still significant, with a mean CGI-I difference of 0.32 (two tailed superiority test; P = 0.016, last observation carried forward) in comparison with venlafaxine after completion of the mandatory treatment period of 6 weeks. The extension to six months of this study showed that the mean score was statistically significantly lower in the agomelatine group than in the venlafaxine group (0.32; P = 0.025), with two-sided Student's test confirmed by the Mann Whitney test, thus indicating a better symptomatic improvement.
Compared to sertraline, treatment with agomelatine demonstrated a significant superiority (two-sided Student's test for independent samples) on CGI ratings both in the CGI severity of illness score (delta of 0.28; P = 0.043) and in the mean CGI global improvement score (delta of 0.29; P = 0.023) after 6 weeks of treatment (last observation carried forward).
Conclusions: The results show that agomelatine significantly improves CGI ratings in comparison with sertraline and venlafaxine, two commonly prescribed antidepressants. These results suggest that agomelatine could be clinically superior to sertraline and venlafaxine in clinical practiceReferences:
1. Audinot, V., Mailliet, F., Lahaye-Brasseur, C., et al. 2003 New selective ligands of human cloned melatonin MT1 and MT2 receptors. Naunyn-Schmiedeberg's Arch Pharmacol. 367:553561.
2. Kennedy, S.H. 2007 Agomelatine: an antidepressant with a novel mechanism of action. Future Neurol. 2:145151.
3. Lemoine, P., Guilleminault, C., Alvarez, E. 2007 Improvement of subjective sleep in major depressive disorder with a novel antidepressant, agomelatine: randomized, double-blind comparison with venlafaxine. J Clin Psychiatry.68:17231732.
Keywords:
Agomelatine
Antidepressants: clinical
Depression: clinical
http://ex2.excerptamedica.com/08ecnp/index.cfm?fuseaction=CIS2002&hoofdnav=Abstracts&content=abs.details&what=AUTHOR&searchtext=L&topicselected=*&selection=ABSTRACT&qryStartRowDetail=114only drawback is that 150mg might not be enough to capture full benefit of venlafaxine.
-D/R
poster:desolationrower
thread:849952
URL: http://www.dr-bob.org/babble/20080822/msgs/850001.html