Servier launches depression treatment in Singapore

In Singapore, about 10 percent of the population could have depression at some point in their lifetime, compared to France (21 percent); US (16.6 percent); New Zealand (16.2 percent); and Italy/Germany (9.9 percent).

The launch of Valdoxan (Agomelatine), an anti-depression drug, is helping to treat patients with the medical condition by resetting their biological clocks (circadian rhythm), restoring daytime alertness and helping them to resume normal sleep patterns.

Analyzing benefits

Dr Calvin Fones, a member of the working group that is responsible for the Ministry Of Health Clinical Practice Guidelines For Depression and a consultant psychiatrist in private practice, commented that the drug compares favorably to existing treatments, with fewer side effects.

"Valdoxan has shown sustained efficacy across a wide range of depressed patients including those severely depressed," says Dr Fones. "The agent has a unique mode of action. It is the first antidepressant with melatonin receptor (MT1) and (MT2) agonist properties and (5-HT2c) antagonist properties. This mode of action allows the drug to reset circadian rhythms of depressed patients and improves sleep without daytime drowsiness. The efficacy comes with a good tolerability profile and is not compromised by sexual side effects, weight gain or discontinuation symptoms."

A study comparing Valdoxan with a Serotonin Norepinephrine Reuptake Inhibitor (SNRI) showed comparable antidepressant efficacy of both treatments, but significantly less sexual dysfunction in patients with the former compared to the SNRI venlafaxine. In addition, a placebo-controlled, double-blind study comparing the treatment with paroxetine showed that after one week of treatment discontinuation, no signs of discontinuation symptoms were seen in the agomelatine group compared to significant discontinuation symptoms in the paroxetine group.

According to Dr Nelson Lee, a consultant psychiatrist in a private practice, this bodes well for patients who are non-compliant with their medication due to side effects. “Among male patients, their top reason for not continuing with their medication is sexual dysfunction, whereas among the women, weight gain is their main concern. If we can remove these side effects, patients are more likely to be compliant with their medication, which will in turn increase their chances of recovery.”

Valdoxan has been registered in Singapore since February 2010. It is also registered in Malaysia, Thailand and Australia. Early trials for the drug were conducted in Europe. Clinical trials in Asia commenced about five years ago. In terms of efficacy and dosing amounts, there were no observed differences between Europeans and Asians.