Agomelatine in generalized anxiety disorder: An active comparator and placebo-controlled study

  • Dan J. Stein
  • , Antti Ahokas
  • , Miguel S. Márquez
  • , Cyril Häschl
  • , Kang Seob Oh
  • , Marek Jarema
  • , Alla S. Avedisova
  • , Cristina Albarran
  • , Valérie Olivier

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

Background: Agomelatine was efficacious in reducing symptoms in a short-term placebo-controlled trial in generalized anxiety disorder (GAD) and in preventing relapse in a longer term placebo-controlled study. An additional short-term placebo-controlled study is required by regulatory agencies to confirm the efficacy of agomelatine in GAD. Method: This 12-week, placebo-controlled, double-blind, randomized, parallel group, international, multicenter study was designed to confirm the efficacy of agomelatine 25 50 mg/d in the treatment of patients with a primary D5M-IV- TR diagnosis of GAD. The primary outcome measure was the Hamilton Anxiety Rating Scale (HARS) total score. Assay sensitivity was evaluated by including an escitalopram (10 20 mg/d) group. Settings:The study was undertaken in 45 clinical centers in Argentina, Czech Republic, Finland, South Korea, Poland, Russia, and Slovakia from April 2010 to July 2011. Results: One hundred thirty-nine outpatients were included in the agomelatine group, 131 in the placebo group, and 142 in the escitalopram group. Agomelatine significantly reduced mean (SD) HARS total score (agomelatine-placebo difference: 4.71 [1.03], P< .0001) and had significant effects on secondary outcome measures, including psychic and somatic HARS subscales, response rate (estimate [standard error]) (agomelatine-placebo difference: 27.4% [5.9%], P <.0001), remission on the HARS (agomelatine-placebo difference: 16.8% [5.4%], P .002), Clinical Global Impressions- Severity of Illness scale (CGI-S) (P <.001), functional impairment (P< .0001), and sleep quality (P< .001). Findings were confirmed in the subset of more severely ill patients (HARS total score >25 with or without CGI S >5 at baseline). Agomelatine was well tolerated by patients, with no more adverse events than placebo. Escitalopram was similarly efficacious but was accompanied by a higher incidence of adverse events compared to placebo. Conclusions: In clinical practice, agomelatine has at least similar efficacy to that of escitalopram for the short-term treatment of GAD and is well tolerated. Trial Registration: Control led-Tria ls.com identifier: 1SRCTN03554974.

Original languageEnglish
Pages (from-to)362-368
Number of pages7
JournalJournal of Clinical Psychiatry
Volume75
Issue number4
DOIs
StatePublished - Apr 2014
Externally publishedYes

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