Farklı Etki Mekanizmasına Sahip Antidepresanların Etkinlik, Bilişsel İşlevler ve Yan Etki Açısından Karşılaştırılması

Çiğdem ERDOĞAN, Hatice ÖZDEMİR REZAKİ, Orhan Murat KOÇAK, Şadiye Visal BUTURAK
2020; 31(2): 90-98
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Comparison of the Effects of Antidepressants with Different Mechanisms of Action on Efficacy, Cognitive Functions and Side Effects

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.
Key Words: Depressive disorder, agomelatine, SSRI, cognitive functioning