AUTHORS ' CONCLUSIONS No available method ologically sound evidence indicates that melatonin or agomelatine is or is not an effective intervention for prevention of SAD and improvement of patient-centred outcomes among adults with a history of SAD .
A well-conducted RCT of melatonin or agomelatine for prevention of SAD would assess the comparative benefits and risks of these interventions against others currently used to treat the disorder
BACKGROUND Seasonal affective disorder ( SAD ) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring .
The prevalence of SAD in the United States ranges from 1.5 % to 9 % , depending on latitude .
The predictable seasonal aspect of SAD provides a promising opportunity for prevention .
This is one of four review s on the efficacy and safety of interventions to prevent SAD ; we focus on agomelatine and melatonin as preventive interventions .
OBJECTIVES To assess the efficacy and safety of agomelatine and melatonin ( in comparison with each other , placebo , second-generation antidepressants , light therapy , psychological therapy or lifestyle interventions ) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD .
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 sertraline.
OBJECTIVE This study evaluates the efficacy of agomelatine , the first antidepressant to be an agonist at MT(1)/MT(2 ) receptors and an antagonist at 5-HT(2C ) receptors , versus sertraline with regard to the amplitude of the circadian rest-activity cycle and depressive and anxiety symptoms in patients with major depressive disorder ( MDD ) . METHOD Out patients with DSM-IV-TR-defined MDD received either agomelatine 25 to 50 mg ( n = 154 ) or sertraline 50 to 100 mg ( n = 159 ) during a 6-week , r and omized , double-blind treatment period . The study was conducted from 2005 to 2006 . The main outcome measure was the relative amplitude of the individual rest-activity cycles , expressed as change from baseline to week 6 and collected from continuous records using wrist actigraphy and sleep logs . Secondary outcome measures were sleep efficiency and sleep latency , both derived from actigraphy , and efficacy on depression symptoms ( 17-Item Hamilton Depression Rating Scale total score and Clinical Global Impressions scale scores ) and anxiety symptoms ( Hamilton Anxiety Rating Scale total score and subscores ) . RESULTS A significant difference in favor of agomelatine compared to sertraline on the relative amplitude of the circadian rest-activity cycle was observed at the end of the first week ( P = .01 ) . In parallel , a significant improvement of sleep latency ( P < .001 ) and sleep efficiency ( P < .001 ) from week 1 to week 6 was observed with agomelatine as compared to sertraline . Over the 6-week treatment period , depressive symptoms improved significantly more with agomelatine than with sertraline ( P < .05 ) , as did anxiety symptoms ( P < .05 ) . CONCLUSIONS The favorable effect of agomelatine on the relative amplitude of the circadian rest-activity/sleep-wake cycle in depressed patients at week 1 reflects early improvement in sleep and daytime functioning . Higher efficacy results were observed with agomelatine as compared to sertraline on both depressive and anxiety symptoms over the 6-week treatment period , together with a good tolerability profile . These findings indicate that agomelatine offers promising benefits for MDD patients . TRIAL REGISTRATION www.is rct n.org : IS RCT N49376288
AUTHORS ' CONCLUSIONS No available method ologically sound evidence indicates that melatonin or agomelatine is or is not an effective intervention for prevention of SAD and improvement of patient-centred outcomes among adults with a history of SAD .
A well-conducted RCT of melatonin or agomelatine for prevention of SAD would assess the comparative benefits and risks of these interventions against others currently used to treat the disorder
BACKGROUND Seasonal affective disorder ( SAD ) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring .
The prevalence of SAD in the United States ranges from 1.5 % to 9 % , depending on latitude .
The predictable seasonal aspect of SAD provides a promising opportunity for prevention .
This is one of four review s on the efficacy and safety of interventions to prevent SAD ; we focus on agomelatine and melatonin as preventive interventions .
OBJECTIVES To assess the efficacy and safety of agomelatine and melatonin ( in comparison with each other , placebo , second-generation antidepressants , light therapy , psychological therapy or lifestyle interventions ) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD .