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Current antidepressant treatments for Major Depressive Disorder (MDD) have limited efficacy and effectiveness. While measurement of response and remission is typically based on overall symptom reduction, the utilization of a dimensional approach, involving mood, cognitive and neurovegetative symptoms, may be more effective in predicting response to different antidepressant classes. In addition to these dimensions, evaluation of function is increasingly recognized as an important patient indicator of antidepressant efficacy. This paper reviews the efficacy of second generation antidepressant classes across the proposed symptom dimensions, and explores the potential benefits of agomelatine. While further research is required, agomelatine generally performed well in the mood dimension including measures of depressed mood, anxiety and anhedonia without inducing emotional blunting. Improvements in daytime alertness and clear thinking, combined with measures of subjective and objective sleep differentiate agomelatine from other currently available antidepressants, and likely contribute to favourable functional outcomes.

A Dimensional Approach to Measuring Antidepressant Response: Implications for Agomelatine