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Journal Club Presentation. Efficacy of the Novel Antidepressant Agomelatine on the Circadian Rest-Activity Cycle and Depressive and Anxiety Symptoms in Patients With Major Depressive Disorder: A Randomized, Double-Blind Comparison With Sertaline. Mohammed Almoslem Pharm.D . Candidate
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Efficacy of the Novel Antidepressant Agomelatine on the Circadian Rest-Activity Cycle and Depressive and Anxiety Symptoms in Patients With Major Depressive Disorder:A Randomized, Double-Blind Comparison With Sertaline
Mohammed AlmoslemPharm.D. Candidate
King Saud University & King Khalid University Hospital
Supervised by: Dr. SolafaFataniMs.c.
Dipiro, et al, pharmacotherapy a pathophysiological approach 7th edition
Demonstrate that agomelatine (25–50 mg/d) improved the circadian rest-activity cycle faster than sertraline in MDD outpatients
Assess the efficacy and tolerability of agomelatine on depressive and anxiety symptoms compared with sertraline through its effect on sleep efficacy and latency
Thase ME. Antidepressant treatment of the depressed patient with insomnia. J Clin Psychiatry. 1999;60(suppl 17):28–31, discussion 46–48. PubMed
Birchler-Pedross A, Schroder CM, Munch M, et al. Subjective well-being is modulated by circadian phase, sleep pressure, age and gender. J Biol Rhythms. 2009;24(3):232–242. PubMed doi:10.17/07487304093546
Boivin DB, Czeisler CA, Dijk DJ, et al. Complex interaction of the sleepwake cycle and circadian phase modulates mood in healthy subjects. Arch Gen Psychiatry. 997;54(2):145–152
The nocturnal disturbances of sleep onset, continuity, and/or awakening, together with daytime retardation and napping, lead to a reduced Relative Amplitude, and that improvement of the former leads to increase of the latter.
ECT: electroconvulsive therapy
Due to absence of treatmentintake or no postbaselineefficacy assessment
RA: relative amplitude. M10: activity of maximum 10 hours. L5: activity of minimum 5 hours.
a: P value, treatment effect: 2-sided Student t test for independent samples.
Abbreviation: LSEQ = Leeds Sleep Evaluation Questionnaire
a: Two-way analysis of covariance with treatment and center (as random effect) as factors and week 0 HDRS total score as covariate.
b: Estimate (standard error) of the difference between adjusted treatment group means: sertraline minus agomelatine.
c: 95% CI of the difference.
d: P value of treatment effect.
Abbreviation: HDRS = Hamilton Depression Rating Scale.
The safety data were not statistically analyzed and only emergent adverseevents (EAEs) that reported by less than 5% of the patients were NOT provided