Comparison of the Effects of Antidepressants with Different Mechanisms of Action on Efficacy, Cognitive Functions and Side Effects

Turk Psikiyatri Derg. 2020 Summer;31(2):90-98. doi: 10.5080/u23704.
[Article in English, Turkish]

Abstract

Objective: The aim of this study was to compare the effects of the agomelatine and selective serotonin reuptake inhibitors (SSRIs) on symptoms of depression, cognitive functions, impulsiveness, suicidal tendency, sleep pattern and side effects.

Method: This study enrolled patients with depression started on SSRIs (n=30) or agomelatine (n=30) on an outpatient basis. All patients were evaluated with SCID-I and the Sociodemographic Questionnaire on the first day of the treatment. In order to assess the side effects of the treatments, the patients were assessed at the first and the fourth weeks with Hamilton Depression Scale (HAM-D), the Suicide Probability Scale (SPS), the UPSS Impulsive Behaviour Scale, the Epworth Sleepiness Scale (ESS), the UKU Side Effect Rating Scale, and the Stroop Test and the Trail Making Test for cognitive functions. .

Results: Patients on SSRIs showed better treatment response and remission rates at the end of the first month. Improvement in cognitive functions correlated with the decrease in depressive symptoms, but no difference was observed between the groups with respect to the improvement of the cognitive functions. SSRIs caused more autonomic and sexual side effects compared to agomelatine. Differences were not observed between the effects of the two medications on impulsivity, sleep pattern and suicidal tendency.

Conclusion: In conclusion, treatment with SSRIs was significantly more associated with improvement in the clinical symptoms. Sexual side effects were more prevalent with SSRIs, but the effect on cognitive functions did not differ from agomelatine Despite the distinct, promising mechanism of action, agomelatine was not as effective as the SSRIs for the treatment of depression.

Publication types

  • Comparative Study

MeSH terms

  • Acetamides / adverse effects
  • Acetamides / pharmacology*
  • Acetamides / therapeutic use
  • Adult
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / pharmacology*
  • Antidepressive Agents / therapeutic use
  • Cognition / drug effects*
  • Depressive Disorder, Major / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sleep / drug effects*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Acetamides
  • Antidepressive Agents
  • Serotonin Uptake Inhibitors
  • agomelatine