Absence of discontinuation symptoms with agomelatine and occurrence of discontinuation symptoms with paroxetine: a randomized, double-blind, placebo-controlled discontinuation study
Montgomery SA, Kennedy SH, Burrows GD,
Lejoyeux M, Hindmarch I.
Imperial College University of London, London, UK;
University Health Network, Toronto, Canada;
Department of Psychiatry, Austin and Repatriation Medical Centre, Victoria, Australia;
Centre Hospitalier Universitaire Louis Mourier, Colombes, France;
HPRU Medical Research Centre, University of Surrey, Guildford, UK.
Int Clin Psychopharmacol. 2004 Sep;19(5):271-280


The effects of an abrupt interruption of agomelatine, a new melatonergic/serotonergic antidepressant, were explored in a double-blind, placebo-controlled study. Paroxetine was used as active control. After 12 weeks of double-blind treatment with agomelatine 25 mg/day or paroxetine 20 mg/day, sustained remitted depressed patients were randomized for 2 weeks, under double-blind conditions, to placebo or to their initial antidepressant treatment. Discontinuation symptoms were assessed at the end of the first and second week of discontinuation with the Discontinuation Emergent Signs and Symptoms (DESS) checklist. One hundred and ninety-two sustained remitted patients were randomized to the 2-week discontinuation period. Patients who discontinued agomelatine did not experience more discontinuation symptoms than those who continued on agomelatine. Patients who discontinued paroxetine for placebo experienced significantly more DESS discontinuation symptoms, during the first week, compared to those who continued with paroxetine (respective mean number of emergent symptoms: 7.3+/-7.1 and 3.5+/-4.1, P<0.001). No significant difference was shown between the continuing and interrupting groups in the second week of discontinuation. By contrast to paroxetine, abrupt cessation of agomelatine is not associated with discontinuation symptoms.
Agomelatine: structure
Paroxetine (Paxil, Seroxat)
Serotonin 5-HT2C receptors
Clinical efficacy of agomelatine
New antidepressants: agomelatine
Agomelatine and bipolar depression
Agomelatine (Valdoxan): efficacy and tolerance profile
Agomelatine, 5-HT2c antagonist and melatonin agonist
Agomelatine and new nerve cell growth in the hippocampus
Agomelatine (Valdoxan) and the serotonin 5-HT2b and 5-HT2c receptors

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