EFFECT OF AGOMELATINE AND SERTRALINE ON PATIENTS WITH MAJOR DEPRESSIVE DISORDERS AND CHRONIC KIDNEY DISEASE: A RANDOMIZED CONTROLLED TRIAL

  • Fadhil A-Hamad Saleh-Arong Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
  • Nattaphon Chokemaitree Department of Psychiatry and Neurology, Phramongkutklao Hospital and College of Medicine
  • Naowanit Nata Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
  • Pamila Tasanavipas Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
  • Narittaya Varothai Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine
  • Bancha Satirapoj Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine
Keywords: Major depressive disorders, Chronic kidney disease, Depression,, Agomelatine, Sertraline

Abstract

Background: Depression is highly prevalent and is well known to affect patients with chronic kidney disease (CKD). Agomelatine exerts psychotropic effects upon mood and anxious states. There is limited data on agomelatine treatment among patients with CKD.

Methods: Patients with CKD stage 3-5 with DSM-5-defined major depressive disorder (MDD) were randomly assigned to receive 25 mg/day of agomelatine or sertraline 50 mg/day for eight weeks at Phramongkutklao Hospital. Hamilton Depression Rating Scale (HDRS) score and concerning adverse events were measured at baseline and the end of the study. Efficacy assessment compared the improvements in clinical response and remission between the agomelatine and placebo groups.

Results: Of 53 enrolled patients, 27 were assigned to the agomelatine group and 26 to the sertraline group. The mean age was 64.8±13.4 years. Baseline characteristics were comparable across treatment groups. After eight weeks, agomelatine-treated showed reductions in HDRS score from baseline (-15.6 with 95% CI -18.6 to -12.5). A significant difference was observed in the reduced HDRS scores between agomelatine and sertraline groups (-12.4; 95% CI -18.4 to -6.5). Over the 6-week treatment period, clinical response (55.0 vs. 9.0%, p <0.001) and remission (45.0 vs. 17.4%, p =0.049) improved significantly more with agomelatine than with sertraline. Both agomelatine and sertraline were well-tolerated during the treatment period.

Conclusion: Agomelatine showed superior antidepressant efficacy over sertraline in treating CKD patients with depression after eight weeks, with a good tolerability profile.

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Published
2022-10-05
How to Cite
1.
A-Hamad Saleh-Arong F, Chokemaitree N, Nata N, Tasanavipas P, Varothai N, Satirapoj B. EFFECT OF AGOMELATINE AND SERTRALINE ON PATIENTS WITH MAJOR DEPRESSIVE DISORDERS AND CHRONIC KIDNEY DISEASE: A RANDOMIZED CONTROLLED TRIAL. J Southeast Asian Med Res [Internet]. 2022Oct.5 [cited 2022Nov.30];60:e0127. Available from: https://www.jseamed.org/index.php/jseamed/article/view/127
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Original Articles