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Is Agomelatine Associated with Less Sedative-Hypnotic Usage in Patients with Major Depressive Disorder? A Nationwide, Population-Based Study

Authors Hsing SC, Jin YT, Tzeng NS, Chung CH, Chen TY, Chang HA, Kao YC, Chien WC

Received 10 April 2020

Accepted for publication 22 June 2020

Published 22 July 2020 Volume 2020:16 Pages 1727—1736

DOI https://doi.org/10.2147/NDT.S257723

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Jun Chen


Shih-Chun Hsing,1,2 Yo-Ting Jin,3,4 Nian-Sheng Tzeng,5,6 Chi-Hsiang Chung,7– 9 Tien-Yu Chen,5,10,11 Hsin-An Chang,5,6 Yu-Chen Kao,5,12 Wu-Chien Chien4,7– 9

1Center for Healthcare Quality Management, Cheng Hsin General Hospital, Taipei, Taiwan; 2Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Heath Sciences, Taipei, Taiwan, Republic of China; 3Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan; 4Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; 5Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; 6Student Counseling Center, National Defense Medical Center, Taipei, Taiwan; 7Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 8School of Public Health, National Defense Medical Center, Taipei, Taiwan; 9Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; 10Department of Psychiatry, Tri-Service General Hospital, Keelung Branch, National Defense Medical Center, Taipei, Taiwan; 11Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; 12Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Keelung, Taiwan

Correspondence: Nian-Sheng Tzeng
Department of Psychiatry, School of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, Taiwan
Tel +886 2-87923311, ext. 17484
Fax +886-2-87927221
Email pierrens@mail.ndmctsgh.edu.tw
Wu-Chien Chien
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, Taiwan
Tel +886 2-87923311, ext. 19189
Fax +886 2-87927235
Email chienwu@ndmctsgh.edu.tw

Background: To examine the association between the usage of agomelatine in patients with major depressive disorder and the usage of sedative-hypnotics.
Methods: This population-based, cross-sectional study used Taiwan’s National Health Insurance Research Database (NHIRD) between 2012 and 2015. The agomelatine-only group and matched control (1:3) with the usage of other antidepressants were enrolled. The association between the usage of the agomelatine and other antidepressants and the usage of sedative-hypnotics in the patients were also assessed.
Results: A total of 7961 subjects were enrolled comprising 1985 with the usage of agomelatine only, and 5976 with other antidepressants. In the present study, a total of 3322 subjects who used the sedative-hypnotics were recorded, with 811 (40.86%) from the agomelatine-only group and 2511 (42.02%) from the non-agomelatine group, which have used sedative-hypnotics. After adjusting for covariates, the odds ratio (OR) of the usage of sedative-hypnotics in the agomelatine only-group was 0.892 (95% CI: 0.306– 1.601, p = 0.533), in comparison to the controls, and the relative risk (RR) of the usage of sedative-hypnotics in the agomelatine only-group was 0.892 0.910 (95% CI: 0.312– 1.633, p = 0.452), in comparison to the controls. No matter as to whether the treatment duration was < 30 days or ≧ 30 days of agomelatine treatment was not associated with the increased usage of the sedative-hypnotics. The OR or RR for usage of the sedative-hypnotics was associated with the Charlson Comorbidity Index (CCI) scores as 2, 3, and ≧ 4, and the medical care from the medical center and regional hospital.
Conclusion: Patients with the agomelatine-only group were not associated with the usage of sedative-hypnotics in comparison to the group using other antidepressants.

Keywords: agomelatine, insomnia, antidepressant, major depressive disorder, National Health Insurance Research Database

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