Agomelatine Augmentation Added to SSRIs or SNRIs for Depression

This is an interventional treatment trial for MDD focused on measuring adjunctive agomelatine, antidepressant therapy, major depressive disorder Read More

Inclusion Criteria:

-1.Aged 18-60 years old; 2.Meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR) criteria for a current major depressive episode; 3.Inadequate response to antidepressants with at least 2-weeks treatment duration and under a standard dose. Inadequate response is defined by a < 20% in the percentage change of HAMD-17 score or according to patients' self-report in antidepressant treatment questionnaire. Standard dose is defined as follows: sertraline: >50mg; fluoxetine: >20 mg; citalopram: >20 mg; escitalopram: >10mg; venlafaxine: >150 mg; duloxetine: >60 mg; 4.Score of Clinical Global Impression-Severity (CGI-S) ≥4; 5.Educational level of junior high school and above, having the ability to give informed consent and complete cognitive tests.

6.The primary providers agreeing and patients willing to maintain current antidepressants with the adjunctive treatment of agomelatine.

Exclusion Criteria:

• 1.Current or history of a systematic medical condition (especially rheumatic-immune systemic diseases, endocrine and metabolism diseases, and neurologic system diseases), brain injury or loss of consciousness for more than 5 minutes; 2.Significant current suicidal ideation or suicidal attempt; 3.Meeting the criteria of substance use disorder according to DSM-5 during the past 6 months; 4.History of adjunctive treatment with antidepressants and/or antipsychotics (allowing a combination of small doses of benzodiazepines); 5.Having used anticoagulants (heparin, warfarin, etc.), glucocorticoids or medications for thyroid diseases in the past 3 months; 6.Abnormal urine toxicology or thyroid screening results; 7.History of seizures or family history of epilepsy; 8.History of antidepressant treatment other than medication within the past six months (i.e. ECT, rTMS, psychotherapy); 9.Pregnant or breast breeding women; 10.Color-blindness 11.Transaminase (ALT and AST) showed in liver function tests 2 times above the upper limit of the normal range; 12.Electrocardiogram examination of QTc ≥ 430 ms in male, QTc ≥ 450 ms in female.