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

• Main Authors: Hsing SC, Jin YT, Tzeng NS, Chung CH, Chen TY, Chang HA, Kao YC, Chien WC
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-07-01
• Series: Neuropsychiatric Disease and Treatment
• Subjects: agomelatine; insomnia; antidepressant; major depressive disorder; national health insurance research database
• Online Access: https://www.dovepress.com/is-agomelatine-associated-with-less-sedative-hypnotic-usage-in-patient-peer-reviewed-article-NDT

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, TaiwanCorrespondence: Nian-Sheng TzengDepartment 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, TaiwanTel [phone], ext. 17484Fax [phone]Email [e-mail]-Chien ChienDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, TaiwanTel [phone], ext. 19189Fax [phone]Email [e-mail]: 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