Psychiatry and Clinical Psychopharmacology (Jul 2019)
Comparison of the effects of sertraline and agomelatine on sleep quality, sexual functioning and metabolic parameters in patients with major depressive disorder
Abstract
OBJECTIVE: This research aims to compare the effects of sertraline and agomelatine on outpatients diagnosed with a “major depressive episode” in terms of sleep quality, sexual functioning, and metabolic parameters related to metabolic syndrome. METHODS: This observational, open-labelled, 12-week follow-up study was carried out in the outpatient psychiatry clinic of a state research hospital. Included in the study were 60 outpatients admitted to the adult psychiatry clinic diagnosed with a “major depressive episode” who were subsequently prescribed agomelatine (25 mg/day) or sertraline (50 mg/day). Arizona Sexual Experience Scale (ASEX) and Pittsburgh Sleep Quality Index (PSQI) were performed during the 1st, 2nd, 4th, 8th and 12th weeks of treatment. The metabolic parameters; Body Mass Index, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, liver enzymes (Alanine transaminase (ALT), Aspartate transaminase (AST) and lipid profiles – total cholesterol and total triglycerides, low density lipoprotein (LDL), high density lipoprotein and very low density lipoprotein – were assessed after the first interview (pre-treatment) and in the 12th week of treatment (post-treatment). RESULTS: The PSQI scores of both the sertraline and agomelatine groups had declined significantly by the end of the follow-up, with the decline in PSQI scores in the agomelatine group being higher than the decline in the sertraline group. The decline in the ASEX scores of the sertraline group was not significant, while the score was significant in the agomelatine group at the end of the follow-up. However, the difference in the changes in the ASEX scores between the study groups was not significant. The unfavourable changes noted in metabolic parameters were: elevation of the mean LDL level in patients using sertraline, and an elevation in liver enzymes (AST and ALT) in the patients using agomelatine. CONCLUSION: The favourable effects of agomelatine on sleep quality and the rapid onset of this effect may be beneficial in particular cases. Agomelatine may be an alternative drug for patients who complain of sexual side effects. Clinicians should evaluate the lipid profile of patients using sertraline, while liver function should be monitored in patients using agomelatine. Neither treatment led to unfavourable outcomes on most of the metabolic parameters.
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