Moclobemide as add-on therapy to agomelatine in a patient with treatment-resistant major depressive disorder: a psychopharmacological case

Štuhec, Matej; Oravecz, Robert

doi:10.1007/s00508-015-0861-0

Cited by 4 publications

(8 citation statements)

References 18 publications

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“…After moclobemide was added to agomelatine, the patient improved significantly and did not experience any serious side effects. 26…”

Section: Resultsmentioning

confidence: 99%

“…20,21 Recently, several articles were published about patients that had achieved remission of their mental illness after combining agomelatine with standard antidepressants like escitalopram, venlafaxine, and other anti-depressive drugs. [22][23][24][25][26] Conversely, there are publications available on agomelatine combinations with duloxetine that describe the development of serious adverse events. 27,28 In summary, the main therapeutic advantages or disadvantages of agomelatine combinations with other antidepressants, and full texts of published articles found on PubMed were analyzed from a pharmacological point of view.…”

Section: Introductionmentioning

confidence: 99%

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What combinations of agomelatine with other antidepressants could be successful during the treatment of major depressive disorder or anxiety disorders in clinical practice?

Potměšil

2019

Therapeutic Advances in Psychopharmacology

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Even with many antidepressant and anxiolytic drugs available on the market, there are still patients who do not respond well to the standard first or second line treatments for affective or anxiety disorders. The antidepressant agomelatine has been used in Europe for several years. Agomelatine, an agonist at melatonin receptors and an antagonist at serotonin receptors, can be particularly useful in patients suffering from a major depressive disorder associated with insomnia. Some clinical data have shown a limited effect for agomelatine in a subset of patients with major depression. A number of case reports published in 2011-2016 describe the effect of agomelatine in combination with an established antidepressant, such as escitalopram, venlafaxine, duloxetine, moclobemide or bupropion. A successful combination of agomelatine was reported after adjunctive use of agomelatine combined with clomipramine, escitalopram, and venlafaxine in patients with major depression or obsessive–compulsive disorder. Moreover, bupropion or moclobemide augmentation with agomelatine in patients with major depressive disorder led to a significant improvement. Other supportive data have been published, such as analysis of the VIVALDI study, although it should be noted that the study was supported by the manufacturer of agomelatine. In this study, agomelatine in combination with other antidepressants was shown to be effective and well tolerated in practice, although the most effective antidepressant treatment in the study consisted of agomelatine alone and not in combination with other antidepressants. There have also been two published case reports about the concomitant use of duloxetine and agomelatine which were not efficacious. The positive results of agomelatine augmentation with other antidepressants should be confirmed through randomized, double-blind clinical trials.

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“…After moclobemide was added to agomelatine, the patient improved significantly and did not experience any serious side effects. 26…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What combinations of agomelatine with other antidepressants could be successful during the treatment of major depressive disorder or anxiety disorders in clinical practice?

Potměšil

2019

Therapeutic Advances in Psychopharmacology

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“…38 One case report depicted successful remission of TRD by combining moclobemide with agomelatine. 39 Another case report showed the combination of bupropion with agomelatine as a successful strategy for TRD. 40 One RCT involving a 12-week treatment period and a double-blind extension for 12 weeks compared agomelatine and escitalopram for efficacy, subjective sleep and tolerability.…”

Section: Agomelatinementioning

confidence: 99%

Experimental Therapeutics in Treatment-Resistant Major Depressive Disorder

Kaur¹,

Sanches²

2021

JEP

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Treatment-Resistant Depression (TRD) patients remain a challenging sub-division of patients with Major Depressive Disorder (MDD) in day to day clinical practice. As with any diagnostic condition, comprehensive evaluation, exclusion of other psychiatric conditions, assessment of co-morbid medical and psychiatric illnesses and psychosocial stressors are the keys to appropriate diagnosis and subsequent management. There are various management options available for the treatment of MDD, however, about 30% of the patients fail to achieve full remission of symptoms despite multiple trials and belong to this sub-category of MDD. This article brings forth discussion of other non-conventional medication and non-medication treatment alternatives that merit exploration of their efficacy in TRD. Many of the proposed novel medications and other treatment modalities such as Deep Brain Stimulation, exercise, yoga are already used for other medical and psychiatric disorders and have some evidence suggesting their potential benefits in TRD in conjunction with conventional medications or even as monotherapy. Nevertheless, more research is needed in this direction to establish effectiveness.

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“…Stuhec et al [124] identified a case with positive evidence of combination moclobemide and agomelatine relieving the symptoms of treatment-resistant MDD, which is otherwise difficult to manage. This case report may serve to help clinicians and clinical pharmacists as a new treatment option for treatment-resistant MDD, although further research is needed to confirm this practice.…”

Section: Atypical Antidepressantsmentioning

confidence: 99%

Possibilities and limitations of antidepressant use to correct depressive and negative symptoms in schizophrenia

Novitsky

Sousa

Asadullin

et al. 2021

jour

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The purpose of this review is to analyze approaches to the treatment of depressive and negative disorders in schizophrenia in terms of their level of efficacy and safety. Materials and Methods: A search was conducted for full-text articles published over the last 10 years in PubMed, Springer, Wiley Online Library, Taylor & Francis Online, APA PsycInfo, CORE, Science Direct, and eLIBRARY.RU databases. Several articles published previously to this period were also included into the review due to their high scientific value. Results: Our review suggests that antidepressants (ADs) are effective medications and they can be prescribed to correct depressive disorders and negative symptoms in patients with schizophrenia when used in combination with antipsychotics (АPs). However, when administering ADs and АPs combinations, it is important to consider the safety profile of these combinations as well as their tolerance. Negative symptoms of schizophrenia, including those induced by a number of АP, are less amenable to correction by АDs monotherapy, which requires a long period of АPs (on average - 8 weeks), which can be limited in the real life of the patient outside the hospital. Current approaches to the therapy of depressive disorders in patients suffering from schizophrenia vary from country to country. However, most of АDs used in clinical psychiatric practice are widely used in the comorbid state under consideration. Conclusion: The efficacy and safety of АDs of the different classes considered in this review depends on their mechanisms of action, duration of admission, type of АPs taken, and specific clinical situation (acute depressive disorder, major depressive episode, or chronic depressive episode). Most promising in clinical practice are serotonin–norepinephrine reuptake inhibitors (SNRIs) and dual ADs. The use of tricyclic antidepressants (TCAs) is limited due to a higher risk of adverse drug reactions (ADRs). The use of most selective serotonin reuptake inhibitors (SSRIs) is limited due to the risk of aggravation of hallucinations (this risk being higher for patients with visual hallucinations, and lower for those with auditory hallucinations) and\or iatrogenic psychosis. These ADRs may probably occur in patients suffering from schizophrenia due to their ideal "poor metabolizer" pharmacogenetic profile, since most of the drugs considered in this review have hepatic metabolism.

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Moclobemide as add-on therapy to agomelatine in a patient with treatment-resistant major depressive disorder: a psychopharmacological case

Cited by 4 publications

References 18 publications

What combinations of agomelatine with other antidepressants could be successful during the treatment of major depressive disorder or anxiety disorders in clinical practice?

What combinations of agomelatine with other antidepressants could be successful during the treatment of major depressive disorder or anxiety disorders in clinical practice?

Experimental Therapeutics in Treatment-Resistant Major Depressive Disorder

Possibilities and limitations of antidepressant use to correct depressive and negative symptoms in schizophrenia

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