Unfortunately, many patients who remit fully or partially from an episode of major depression with regular antidepressants have difficulties in the first four weeks of the treatment.

Our report assesses whether agomelatine has more rapid onset of effect or not in a major depressive patient.

A 28-years-old man with current major depressive disorder defined using DSM-IV-TR criteria was started to treat with 25 mg/day agomelatine. He was evaluated by daily CGI-S, BDI, HAMD-17, PSQI, and ISI during the treatment course.

The significant response has occurred at the 5th day of the antidepressant treatment. The term of response represents a clinically meaningful degree of reduction in depressive symptoms here (i.e. ≥50% reduction in baseline severity assessed by HAMD-17).

Agomelatine has approved in October 2011 for the treatment of depression in Turkey. This new antidepressant might produce earlier symptom improvement than comparator traditional antidepressants with its novel pharmacological profile as an agonist at melatonergic (MT1 and MT2) receptors and antagonist at 5-HT2C receptors. And, early symptom relief may, in part, be related to its regulatory effects on circadian and sleep-wake cycles. Finally, this therapeutic benefit suggests that agomelatine can be considered a first-line treatment for patients with major depression.