SS05-02 - Management of depression with agomelatine: A different perception

2011 ◽  
Vol 26 (S2) ◽  
pp. 2178-2178
Author(s):  
G. Hajak
Keyword(s):  
Side Effects ◽  
Antidepressant Treatment ◽  
Real Life ◽  
Daily Practice ◽  
Early Improvement ◽  
Real Life Setting ◽  
Treatment Of Depression ◽  
Perceived Benefit ◽  
Antidepressant Efficacy ◽  
Clinical Benefits

Agomelatine is a completely new approach to the treatment of depression thanks to its innovative mode of action. Acting as melatonergic agonist and 5-HT2C antagonist, it provides depressed patients with a distinctive antidepressant efficacy that perfectly suits patients’ needs and addresses all symptoms at each step of depression. Two years after the first launch in Europe, now is the time for an update from doctors and patients alike.The patient/doctor relation is key when initiating depression treatment, because patients are reluctant to start, fearing withdrawal symptoms, serious unwanted side effects, and “addiction”. It is important therefore that they understand that agomelatine has none of these effects.The benefits perceived by patients right from the first days of treatment are influential, because patients are reluctant to continue with classic antidepressants (delayed onset of perceived benefit, early side effects). The early improvement reported by patients on agomelatine supplements data on clinical benefits seen in clinical trials from the first week versus venlafaxine (CGI-I, rate of response, daytime alertness, feeling good) and after two weeks versus sertraline (twice as many HAM-D responders to agomelatine as to sertraline).Finally, patients are reluctant to maintain antidepressant treatment because of later side effects (weight gain, sexual dysfunction, emotional blunting). Patients on agomelatine confirm the absence of the classic side effects of antidepressants and are more likely to continue treatment than they are with other drugs. Both the antidepressant efficacy and the tolerability were confirmed in a large non-interventional study in a real-life setting in daily practice.

Antidepressant efficacy and tolerance of agomelatine in daily practice in Switzerland

2016 ◽  
Vol 33 (S1) ◽  
pp. S412-S412
Author(s):  
B. Guido ◽  
H.T. Edith
Keyword(s):  
Remission Rate ◽  
Real Life ◽  
Daily Practice ◽  
Liver Function Tests ◽  
Weight Changes ◽  
Depressed Patients ◽  
Remission Rates ◽  
Antidepressant Efficacy ◽  
Competing Interest

IntroductionThe antidepressant efficacy and tolerance of agomelatine, MT1/MT2 agonist and 5-HT2C antagonist, has been proven in clinical trials. Non interventional studies give the opportunity to evaluate these properties in real life.ObjectiveTo evaluate the efficacy and tolerance of agomelatine in depressed outpatients in Switzerland.MethodsNon-interventional study in 934 depressed (51.2% severely) patients given 25–50 mg agomelatine for 12 and 24 weeks. Main endpoints were change in MADRS score, and response (≥50% reduction in total score) and remission (MADRS ≤12) rates. CGI was also assessed. Reported adverse drug reactions, sexual dysfunction, and weight changes were recorded. Liver function tests were performed according to the summary of product characteristics.ResultsMADRS total score decreased significantly (P < 0.0001) from baseline (29.5 ± 8.9) to weeks 12 (12.8 ± 9.6) and 24 (9.7 ± 8.6). Responder rate was 66.8% and 78.3% and remission rate 54.2% and 70.2% at weeks 12 and 24, respectively. Results corroborated by CGI scores, were similar for severely depressed patients. Early improvers (MADRS ≥ 20% reduction after 2 weeks; 461 patients) had the highest responder and remission rates. Agomelatine was well tolerated and no relevant weight changes or deleterious sexual function was reported. Ten patients had ALT/AST>3ULN, thereof 2 without baseline and one with elevated baseline. Most physicians rated the efficacy and tolerance of agomelatine as “good or very good”.ConclusionLong-term agomelatine treatment improved mood symptoms of depressed patients with high levels of response and remission and a favorable tolerance profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatments for Depression

2013 ◽  
pp. 508-514
Author(s):  
Dan V. Iosifescu ◽  
James W. Murrough ◽  
Dennis S. Charney
Keyword(s):  
Treatment Outcome ◽  
Side Effects ◽  
Mechanisms Of Action ◽  
Special Populations ◽  
Significant Morbidity ◽  
Antidepressant Treatments ◽  
Treatment Of Depression ◽  
Antidepressant Efficacy ◽  
Natural Remedies ◽  
Significant Data

Since major depression is associated with significant morbidity and functional impairment, effective treatments are very important. This chapter reviews several categories of currently available antidepressant treatments (including the major classes of pharmacotherapies, somatic treatments, psychotherapies and natural remedies), attempting to review key findings regarding mechanisms of action, antidepressant efficacy and major side effects. We will also review significant data related to biomarkers of treatment outcome and to treatment of depression in special populations (e.g., psychotic, melancholic, atypical, postpartum, bipolar). We will conclude with a review of future antidepressant treatments currently in development.

scholarly journals Evaluation of care in neonatal-perinatal medicine

1997 ◽  
Vol 2 (4) ◽  
pp. 262-266
Keyword(s):  
Side Effects ◽  
Perinatal Care ◽  
Clinical Importance ◽  
Daily Practice ◽  
Perinatal Medicine ◽  
Maternal Fetal Medicine ◽  
Clinical Benefits ◽  
New Treatments ◽  
Evaluation Of Care

Abstract OBJECTIVE: To assist providers of neonatal-perinatal care in the evaluation of present and future practices to optimize benefits for patients. METHODS: Members of the Canadian Paediatric Society Fetus and Newborn Committee and the Society of Obstetricians and Gynaecologists of Canada Maternal-Fetal Medicine Committee reviewed published information on principles of evaluation of care. Selections of published clinical trials in neonatal-perinatal care were used to illustrate specific items. RESULTS: After determining the clinical importance of the area to be considered, appropriate methods should be used to evaluate the quality of evidence and the strength of recommendations. The ability to generalize information to guide care of specific patients must be determined. Consideration of costs may use recognized criteria that consider effectiveness, side effects, financial implications and quality of life. CONCLUSION: Introduction of new treatments to daily practice should be based on demonstrated clinical benefits of treatment, relative freedom from unwanted side effects and cost effectiveness. Application of these principles for neonatal-perinatal care (and other areas) is essential for the modern clinician.

scholarly journals Pharmacogenomic study of side-effects for antidepressant treatment options in STAR*D

2011 ◽  
Vol 42 (6) ◽  
pp. 1151-1162 ◽  
Author(s):  
S. L. Clark ◽  
D. E. Adkins ◽  
K. Aberg ◽  
J. M. Hettema ◽  
J. L. McClay ◽  
...  
Keyword(s):  
Side Effects ◽  
Antidepressant Treatment ◽  
Association Studies ◽  
Treatment Options ◽  
Antidepressant Medication ◽  
Genome Wide Association Studies ◽  
Nucleotide Polymorphisms ◽  
Sexual Side Effects ◽  
Genome Wide ◽  
Treatment Of Depression

BackgroundUnderstanding individual differences in susceptibility to antidepressant therapy side-effects is essential to optimize the treatment of depression.MethodWe performed genome-wide association studies (GWAS) to search for genetic variation affecting the susceptibility to side-effects. The analysis sample consisted of 1439 depression patients, successfully genotyped for 421K single nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Outcomes included four indicators of side-effects: general side-effect burden, sexual side-effects, dizziness and vision/hearing-related side-effects. Our criterion for genome-wide significance was a prespecified threshold ensuring that, on average, only 10% of the significant findings are false discoveries.ResultsThirty-four SNPs satisfied this criterion. The top finding indicated that 10 SNPs inSACM1Lmediated the effects of bupropion on sexual side-effects (p=4.98×10−7,q=0.023). Suggestive findings were also found for SNPs inMAGI2,DTWD1,WDFY4andCHL1.ConclusionsAlthough our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that could mediate adverse effects of antidepressant medication.

scholarly journals Sex differences in the psychopharmacological treatment of depression

2016 ◽  
Vol 18 (4) ◽  
pp. 447-457 ◽  
Keyword(s):  
Sex Differences ◽  
Antidepressant Treatment ◽  
Behavioral Differences ◽  
Sex Effects ◽  
Psychopharmacological Treatment ◽  
Treatment Of Depression ◽  
Antidepressant Efficacy ◽  
Physiological Differences

Although a number of studies have observed that females respond better to serotonergic antidepressants than males and that postmenopausal females have a diminished response to antidepressants compared with younger females, there are also studies that conflict with both of these findings, making any generalizations regarding sex differences difficult to make. Sex variance in antidepressant efficacy and pharmacokinetics profiles have been attributed to sex-based physiological differences, behavioral differences, related disorders, and sex-specific conditions, including pregnancy and menopause. This paper will review the history and current research on sex effects of antidepressant treatment.

Antidepressant treatment patterns in younger and older adults from the general population in a real-life setting

2014 ◽  
Vol 29 (9) ◽  
pp. 928-935 ◽  
Author(s):  
Fanny Etchepare ◽  
Thibaut Sanglier ◽  
Manon André ◽  
Hélène Verdoux ◽  
Marie Tournier
Keyword(s):  
Older Adults ◽  
General Population ◽  
Antidepressant Treatment ◽  
Real Life ◽  
Treatment Patterns ◽  
Real Life Setting

scholarly journals Antidepressant Treatment of Depression in the Elderly: Efficacy and Safety Considerations

2021 ◽  
Vol 05 (04) ◽  
pp. 1-1
Author(s):  
Trevor R Norman ◽  
Keyword(s):  
Elderly Patients ◽  
Antidepressant Treatment ◽  
Clinical Problem ◽  
The Elderly ◽  
Term Treatment ◽  
Considerable Proportion ◽  
Treatment Of Depression ◽  
Long Term Treatment ◽  
Antidepressant Efficacy ◽  
Safety Considerations

Depression in the elderly is a significant clinical problem which is likely to endure as an ongoing issue as the cohort of individuals aged over 65years continues to increase as a proportion of the total population. While there are a multiplicity of approaches to the treatment of depression, the mainstay for moderate to severe cases is pharmacotherapy. The majority of extant antidepressants have demonstrated efficacy, at least in short term (6-12weeks) clinical evaluations. There is demonstrable efficacy over and above that of placebo in the majority of clinical trials for most agents. Within the classes of antidepressants there is no difference between individual agents, while between classes differences have not been demonstrated consistently. Thus, there appears to be little to choose between the various agents. However, considerations other than efficacy play a role in the choice of an antidepressant for an individual patient. A systematic review of the efficacy of antidepressant agents based on trials in elderly populations is presented. Factors influencing the choice of a medication over and above efficacy are presented along with a brief review of adverse events of particular concern in elderly patients. A considerable proportion of elderly patients have comorbid medical conditions, which may also influence the choice of agent due to drug-drug interaction considerations. A brief overview of interactions likely to influence medication selection is also canvassed. While there is every reason to be optimistic about outcomes in elderly patients, there are still unanswered questions about antidepressant efficacy in this population: effectiveness in long-term treatment and in the population of so-called ‘old-old’ elderly are principal among them.

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