Agomelatine in the treatment of anhedonia, somatic symptoms, and sexual dysfunction in major depressive disorder

Abstract

Objective: This study evaluated the treatment outcomes of agomelatine on anhedonic state, anxiety/somatic symptoms, and sexual function in Chinese patients with major depressive disorder (MDD).

Method: In total, 93 adult patients with MDD were enrolled, and 68 of them were included in a prospective, open-label, multicenter clinical study. All patients received agomelatine monotherapy during a 9-week treatment phase. The effectiveness of the treatment was reflected by the improvement of anhedonia and somatic symptoms based on the 17-item Hamilton Depression Rating Scale (HAMD-17). In addition, the Arizona Sexual Dysfunction Scale (ASEX), Sheehan Disability Scale (SDS), and Short Form of Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) were administered to all participants at baseline and at the 3-, 6-, and 9-week follow-ups.

Results: After 9 weeks of treatment with agomelatine, the response and remission rates were 73.5% and 39.7%, respectively. Somatic symptoms significantly improved at week 9 (p < 0.001), and significant effects were also observed on the HAMD anhedonia items (p < 0.001). The patients exhibited lower levels of disease severity (the SDS score dropped from 15.52 ± 4.7 to 7.09 ± 5.62 at week 9; the ASEX score dropped from 21.89 ± 4.06 to 16.19 ± 4.79, p < 0.001) and higher levels of QOL (the Q-LES-Q-SF score dropped from 41.02 ± 5.99 to 50.49 ± 8.57, p < 0.001) during the follow-up. Furthermore, treatment with agomelatine improved depressive symptoms without causing serious adverse events.

Conclusion: These analyses indicate that agomelatine is a treatment option for improving anhedonic status, anxiety/somatic symptoms, and sexual dysfunction in MDD patients.

Keywords: agomelatine; anhedonia; major depressive disorder; sexual dysfunction; somatic symptoms.

Figure 1

Flow chart of the study procedure.

Figure 2

Variations in (A) HAMD-17 anxiety/somatic, (B) Q-LES-Q-SF, (C) SDS, and (D) ASEX scores. Results are expressed as mean ± SD, analysis of variance for repeated measures. ***Statistically significant difference from baseline (P < 0.001). Error bars represent standard deviations. HAMD-17, 17-item Hamilton Depression Rating Scale; QIDS-SR, quick inventory of depressive symptomatology self-report; CGI-S, clinical global impression scale; Q-LES-Q-SF, quality-of-life enjoyment and satisfaction questionnaire-short form; ASEX, Arizona sexual experiences scale; SDS, Sheehan Disability Scale.