Discussion
OCD-related, sleep disturbance, OCD, insomnia
ADVERSE EFFECTS
We did not find a significant difference between agomelatine and placebo in augmentation with sertraline, in improving the symptoms of moderate to severe OCD. The observed adverse effects were mild and did not cause withdrawal. Furthermore, the frequency and severity of adverse effects were not notably different between the two groups.Our results tie well with another clinical trial [Similar to our study, all the previous studies [None of the patients included in our study suffered from substantial sleep disturbance at the initial evaluation, and the incidence of insomnia was not significantly different between the groups. However, a clinical trial [The exact OCD-related mechanism of action and clinical effects of agomelatine are still unclear, but it has been shown to be effective in the resynchronization of circadian rhythms, selectively enhancing the frontocortical dopaminergic pathway, enhancing the frontocortical adrenergic pathway, promotion of hippocampal neurogenesis (by increasing brain-derived neurotrophic factor (BDNF)), and increasing the activity of hypothalamic–pituitary–adrenal (HPA) axis [