Effect of agomelatine 25-50 mg on functional outcomes in patients with major depressive disorder

Purpose: The purpose of this work is to investigate the effect of agomelatine on functioning compared with placebo in patients suffering from Major Depressive Disorder (MDD). Methods: Data from two randomized, parallel, double-blind, placebo-controlled short-term agomelatine trials conducted by the manufacturer, one in adult and one in older patients, that evaluated the effect on social functioning, were pooled. The short term effect of agomelatine on social functioning was assessed using the Sheehan Disability Scale (SDS), according to SDS total and sub-item scores, as well as on functional response and remission rates. The Hamilton Depression rating scale was used to quantify severity of depression symptoms. A meta-analytic method using a random effect model was used to assess differences in treatment. Results: In total, 633 patients (422 on agomelatine; 211 on placebo) were included in the analyses. At endpoint, there was a significant difference in favor of agomelatine vs placebo of 3.47 (0.62) (95% confidence interval: [2.26; 4.67]; P<0.001) on the SDS total score. Rates of symptomatic response and remission according to HAM-D-17 total score were significantly higher in patients taking agomelatine (54.3% and 18.3% respectively) than in those taking placebo (29.4% and 9.5% respectively) with respective differences of 24.9%, p<0.001 and 9.3%, p<0.001. The functional response rates were 52.9% on agomelatine and 34.5% on placebo, with a significant placebo-agomelatine difference in favor of agomelatine of 18.30 +/- 4.39% (95% CI: [9.69; 26.91], p<0.001). The functional remission rates were 22.3% with agomelatine and 10.2% with placebo, with a significant difference in favor of agomelatine of 11.7 +/- 3.11% (95% CI: [5.61; 17.79], p<0.001). Combined symptomatic and functional response rates were 42.1% on agomelatine and 23.2% on placebo (p<0.001), and the combined symptomatic and functional remission rates were 13.9% on agomelatine and 6.8% on placebo (p<0.005). Conclusion: This study confirms the efficacy of agomelatine in improving social functioning in MDD patients.