The Effects of Fluoxetine and Agomelatine on Neurocognitive Functions and Sleep in Patients with Major Depressive Disorder

Overview

Journal Psychiatry Clin Psychopharmacol

Publisher Aves

Specialty Psychiatry

Date 2024 Jun 17

PMID 38883888

Authors

Esat Fahri Aydin

Mustafa Gulec

Elif Oral

Ali Gokhan Daloglu

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to evaluate the effects of 6 weeks of agomelatine versus fluoxetine treatment on cognition and sleep.

Methods: Agomelatine 25 mg/day and fluoxetine 20 mg/day were administered to major depressive disorder (MDD) patients. Assessments were conducted before the treatment and at the sixth week of treatment via psychometric measures and comprehensive neurocognitive assessments of various functions, including executive skills, attention, memory, verbal fluency, and speed of processing.

Results: They both improved the evaluated neurocognitive test scores ( < .05), except for the scores of the Digit Span Test ( > .05), but only fluoxetine significantly improved the scores of the Controlled Oral Word Association Test ( = .018). Only in relation to the subjective sleep quality part of the Pittsburgh Sleep Quality Index ( = .035) and the Trail Making Test-B (TMT-B) ( = .046) was there an important difference between the study groups, and agomelatine showed better effects than fluoxetine in these measures.

Conclusion: Both drugs improved the neurocognitive functioning in the participants. However, the better effect of agomelatine in improving the TMT-B scores suggests that it is a suitable option for MDD patients with noticeable executive disturbances.

References

Taylor B, Bruder G, Stewart J, McGrath P, Halperin J, Ehrlichman H . Psychomotor slowing as a predictor of fluoxetine nonresponse in depressed outpatients. Am J Psychiatry. 2006; 163(1):73-8. DOI: 10.1176/appi.ajp.163.1.73. View

Gaynes B, Lux L, Gartlehner G, Asher G, Forman-Hoffman V, Green J . Defining treatment-resistant depression. Depress Anxiety. 2019; 37(2):134-145. DOI: 10.1002/da.22968. View

Gupta K, Gupta R, Bhatia M, Tripathi A, Gupta L . Effect of Agomelatine and Fluoxetine on HAM-D Score, Serum Brain-Derived Neurotrophic Factor, and Tumor Necrosis Factor-α Level in Patients With Major Depressive Disorder With Severe Depression. J Clin Pharmacol. 2017; 57(12):1519-1526. DOI: 10.1002/jcph.963. View

Corruble E, de Bodinat C, Belaidi C, Goodwin G . Efficacy of agomelatine and escitalopram on depression, subjective sleep and emotional experiences in patients with major depressive disorder: a 24-wk randomized, controlled, double-blind trial. Int J Neuropsychopharmacol. 2013; 16(10):2219-34. DOI: 10.1017/S1461145713000679. View

Keefe R, McClintock S, Roth R, Doraiswamy P, Tiger S, Madhoo M . Cognitive effects of pharmacotherapy for major depressive disorder: a systematic review. J Clin Psychiatry. 2014; 75(8):864-76. DOI: 10.4088/JCP.13r08609. View

Subramaniapillai M, Mansur R, Zuckerman H, Park C, Lee Y, Iacobucci M . Association between cognitive function and performance on effort based decision making in patients with major depressive disorder treated with Vortioxetine. Compr Psychiatry. 2019; 94:152113. DOI: 10.1016/j.comppsych.2019.07.006. View

Millan M . Agomelatine for the treatment of generalized anxiety disorder: focus on its distinctive mechanism of action. Ther Adv Psychopharmacol. 2022; 12:20451253221105128. PMC: 9251978. DOI: 10.1177/20451253221105128. View

Martin D, Wollny-Huttarsch D, Nikolin S, McClintock S, Alonzo A, Lisanby S . Neurocognitive subgroups in major depressive disorder. Neuropsychology. 2020; 34(6):726-734. DOI: 10.1037/neu0000626. View

Parkinson W, Rehman Y, Rathbone M, Upadhye S . Performances on individual neurocognitive tests by people experiencing a current major depression episode: A systematic review and meta-analysis. J Affect Disord. 2020; 276:249-259. DOI: 10.1016/j.jad.2020.07.036. View

10.

Bastos A, Santos Pinto Guimaraes L, Trentini C . Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy. J Affect Disord. 2013; 151(3):1066-75. DOI: 10.1016/j.jad.2013.08.036. View

11.

Ling A, Lim M, Gwee X, Ho R, Collinson S, Ng T . Insomnia and daytime neuropsychological test performance in older adults. Sleep Med. 2016; 17:7-12. DOI: 10.1016/j.sleep.2015.07.037. View

12.

Clark M, DiBenedetti D, Perez V . Cognitive dysfunction and work productivity in major depressive disorder. Expert Rev Pharmacoecon Outcomes Res. 2016; 16(4):455-63. DOI: 10.1080/14737167.2016.1195688. View

13.

Jobson D, Hase Y, Clarkson A, Kalaria R . The role of the medial prefrontal cortex in cognition, ageing and dementia. Brain Commun. 2021; 3(3):fcab125. PMC: 8249104. DOI: 10.1093/braincomms/fcab125. View

14.

Allott K, Fisher C, Amminger G, Goodall J, Hetrick S . Characterizing neurocognitive impairment in young people with major depression: state, trait, or scar?. Brain Behav. 2016; 6(10):e00527. PMC: 5064339. DOI: 10.1002/brb3.527. View

15.

Marrocco J, Reynaert M, Gatta E, Gabriel C, Mocaer E, Di Prisco S . The effects of antidepressant treatment in prenatally stressed rats support the glutamatergic hypothesis of stress-related disorders. J Neurosci. 2014; 34(6):2015-24. PMC: 6608531. DOI: 10.1523/JNEUROSCI.4131-13.2014. View

16.

Yu L, An C, Jia L, Li Y, Chen Q, Zhen F . Combination Therapy of Salvianolic Acid and Fluoxetine Improves the Cognitive Function of Rats with Chronic Stress-induced Depression. World Neurosurg. 2015; 86:173-80. DOI: 10.1016/j.wneu.2015.09.071. View

17.

Ott T, Nieder A . Dopamine and Cognitive Control in Prefrontal Cortex. Trends Cogn Sci. 2019; 23(3):213-234. DOI: 10.1016/j.tics.2018.12.006. View

18.

Lu Y, Ho C, McIntyre R, Wang W, Ho R . Agomelatine-induced modulation of brain-derived neurotrophic factor (BDNF) in the rat hippocampus. Life Sci. 2018; 210:177-184. DOI: 10.1016/j.lfs.2018.09.003. View

19.

Hammar A, Ronold E, Rekkedal G . Cognitive Impairment and Neurocognitive Profiles in Major Depression-A Clinical Perspective. Front Psychiatry. 2022; 13:764374. PMC: 8957205. DOI: 10.3389/fpsyt.2022.764374. View

20.

Cipriani A, Furukawa T, Salanti G, Chaimani A, Atkinson L, Ogawa Y . Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018; 391(10128):1357-1366. PMC: 5889788. DOI: 10.1016/S0140-6736(17)32802-7. View