[The temporal accuracy of agomelatine administration and comparison of antidepressant effect of agomelatine and escitalopram in major depression: a retrospective investigation at a psychiatric outpatient clinic].

Aim: The assessment of antidepressant efficacy of agomelatine, a new chronobiological type of antidepressant as a function of the temporal accuracy of administration, compared to the antidepressive effect of escitalopram.

Methods: In our retrospective study at the end of a 12-week treatment improvement rates were analysed in all depressed patients attending our ourpatient clinic receiving agomelatine (25 or 50 mg daily) or escitalopram (10 or 20 mg daily) monotherapy initiated between 01. 03. 2014 and 01. 03. 2015 Follow-up interviews were conducted to evaluate temporal accuracy of agomelatine administration in the evenings and we divided our group into accurately and inaccurately administered agomelatine groups.

Results: In the inaccurately administered agomelatine group (n=16) after 12 weeks 7 patients (43.7%) showed no improvement, 7 patients showed response (43.7%), and two entered remission (12.5%). In the accurately administered agomelatine group (n=63) 18 patients showed no improvement (28.6%), 15 were responders (23.8%) and 30 patients entered remission (47.6%). Regarding the improvement rates there was a significant difference between the two agomelatine groups (p=0.034). Comparing the 12-week improvement ratio of the accurate agomelatine group to all patients in the outpatient practice (n=62) receiving escitalopram (30 vs 29 remitters, 15 vs 15 responders, and 18 vs 18) no difference in improvement rates was shown between groups (p= 0.982).

Conclusions: Our results show for the first time that the accuracy of administration of evening agomelatine medication has a crucial importance in terms of efficacy, furthermore confirm the results of previous international clinical trials that the antidepressant agomelatine exerts the same strength of antidepressant effect as the clinically proven escitalopram.