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Comparison of agomelatine and escitalopram on nighttime sleep and daytime condition and efficacy in major depressive disorder patients

Quera-Salva, Maria-Antoniaa; Hajak, Goerand; Philip, Pierreb; Montplaisir, Jaquese; Keufer-Le Gall, Sophiec; Laredo, Judithc; Guilleminault, Christianf

International Clinical Psychopharmacology: September 2011 - Volume 26 - Issue 5 - p 252–262
doi: 10.1097/YIC.0b013e328349b117
Original Articles

Agomelatine, an MT1/MT2 receptor agonist and 5-HT2C receptor antagonist antidepressant, is known to have beneficial effects on subjective sleep in major depressive disorder patients. This international multicenter, randomized, double-blind study compared the effects of agomelatine (25–50 mg/day) and escitalopram (10–20 mg/day) on sleep polysomnographic parameters in major depressive disorder patients treated up to 24 weeks. A total of 138 outpatients were randomly allocated to agomelatine (n=71) or escitalopram (n=67). Treatment with agomelatine was associated with a reduction in sleep latency from week 2 onward. The difference between treatments was significant on all evaluations. Rapid eye movement latency was increased with escitalopram compared with agomelatine, with significant between-group differences at every visit. Agomelatine preserved the number of sleep cycles, whereas it was decreased with escitalopram with significant between-group differences at every visit. Assessments on visual analogue scales indicated that treatment with agomelatine improved morning condition, and reduced daytime sleepiness compared with escitalopram.

17-item Hamilton depression rating scale total score was reduced in both groups, agomelatine was statistically noninferior to escitalopram at 6 weeks. Both treatments were well tolerated. This study showed that the clinical effects of agomelatine on sleep and wake parameters are different from that of escitalopram.

aAP-HP Sleep Unit, Raymond Poincaré Hospital, Garches

bGENPPHASS , Explorations fonctionnelles du SNC, CHU Pellegrin-Tripode, Bordeaux

cIRIS, Division Thérapeutique de Neuropsychiatrie, Courbevoie, France

dDepartment of Psychiatry Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany

eDepartment of Psychiatry and Canadian Research Chair in Sleep Medicine, Université de Montreal, Montreal, Quebec, Canada

fStanford University, Sleep Medicine Program, Stanford, California, USA

Correspondence to Dr Maria-Antonia Quera-Salva, Department of Physiology, Sleep Unit, Raymond Poincaré Hospital, Garches 92380, France Tel: +33 1 47 10 79 40; fax: +33 1 47 10 79 43; e-mail:

Received March 2, 2011

Accepted June 8, 2011

© 2011 Lippincott Williams & Wilkins, Inc.