Objective:To explore the efficacy and safety of agomelatine in comparison with selective serotonin reuptake inhibitors（SSRIs）and serotonin noradrenaline reuptake inhibitor（SNRIs）used as anti-depressants in treatment of depressive disorder. Methods:Computer retrieval Cochrane library

Pubmed

Elsevier

CNKI

VIP

CBM

Wan Fang electronic database searches were performed to identify reports of head-to-head randomized controlled trials that have compared agomelatine with SSRIs or SNRIs in terms of efficacy/effectiveness in treating depressive disorder. The clinical trails meet the eligibility criteria for quality evaluation and information were extracted

and the Rev Man 5.2 statistic software was used for Meta analysis. Results:A total of 8 RCTs were enrolled including 2 632 patients. Meta-analysis results showed that agomelatine had higher response rates（RR=1.07

95%CI=1.01 to 1.12

P=0.010）compared with SSRIs and SNRIs. In the remission analysis

remission rates（RR=1.10

95%CI=1.01 to 1.20

P=0.030）were significantly different.Depression scale at the end of the scale and the baseline values was higher than in agomelatine group than in SSRI or SNRI drug groups（MD=0.46

95%CI=-0.13 to 1.05

P=0.130）without significant differences between the two groups. Agomelatine group was superior to SSRIs and SNRIs groups in side effects（RR=0.50

95%CI=0.37 to 0.68

P=0.000）. Conclusion:Agomelatine has significantly higher efficacy and lower side effects compared with SSRIs and SNRIs when treating depression. However

this conclusion needs further validation by high quality and large sample RCTs.