Clinical Psychopharmacology and Neuroscience Papers in Press available online.

The effect of Agomelatine in Behavioral and Psychological Symptoms of Dementia
Carol Sheei-Meei Wang 1,2,3, Kuo-Sheng Cheng 1, Chia-Hung Tanag 2, Ming-Chyi Pai 4,*, Pai-Lien Chen 5, Pei-Fang Chien 2
1Department of BioMedical Engineering, National Cheng Kung University, Tainan, Taiwan, 2Department of Psychiatry, Tainan Hospital, Department of Health Executive Yuan, Tainan, Taiwan , 3Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 4Divsion of Behavioral Neurology, Department of Neurology and Alzheimer’s Disease Center, National Cheng Kung University Hospital, Medical College, National Cheng Kung University, Tainan City, Taiwan , 5Biostatistics and Data Science Department, FHI 360, USA, Durham, North Carolina, USA
Objective: Moderate and severe behavioral and psychological symptoms of dementia (BPSD) often need medical treatment to improve symptoms. Agomelatine is a selective melatonergic (MT1/MT2) agonist that has normalizing effects on disturbed circadian rhythms and disrupted sleep–wake cycles. Its activity of 5HT-2C receptor antagonism is associated with lessening depression and anxiety and increasing slow-wave sleep. Based on past clinical records and current findings it suggests that agomelatine can improve BPSD for patients. This retrospective cohort study was designed to compare the BPSD before and after using agomelatine.
Methods: Records of dementia cases who had ever received agomelatine treatment for BPSD in a general hospital setting during the past 2.5 years were identified and reviewed. Scores from before and after 3 months of treatment with agomelatine were collected for Neuropsychiatric Inventory (NPI), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression (CGI) to compare and analyze the difference of psychological and behavioral symptoms pre- and post-agomelatine used.
Results: Records of 144 cases of dementia with BPSD who had ever used agomelatine from January 2015 to June 2017 were collected. All of the 112 cases had BPRS and CGI scores, of which 75 cases had additional NPI scores. Among these 112 cases, the BPRS and CGI scores were significantly improved in all types of dementia. NPI scores indicated that the use of agomelatine alleviated obvious symptoms and decreased overall distress, especially in the depression/poor mood, anxiety, and sleep/night behavior.
Conclusion: It is consistent with an effective result of agomelatine in improving BPSD.
Accepted Manuscript [Submitted on 2021-07-21, Accepted on 2021-11-03]