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Agomelatine in Depressive Disorders

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Melatonin and Melatonergic Drugs in Clinical Practice

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Abstract

Major depressive disorder (MDD) is a debilitating disease with significant personal, social, and economic burden and continues to be the leading cause of disability worldwide. Disappointing rates of remission following treatment with first-line antidepressants primarily targeting the serotonin and norepinephrine systems have provided the impetus for developing alternative treatments targeting novel mechanisms. There is a strong association between MDD and disturbances in circadian rhythm. Agomelatine is a novel antidepressant with actions on the melatonergic system which play a fundamental role in synchronizing circadian rhythms. Its actions as a melatonin receptor (M1 and M2) agonist and as a serotonin receptor (5-HT2c) antagonist also trigger increased dopamine activation in the frontal cortex and decreased glutamatergic actions elsewhere in the brain. Compared to other first-line antidepressants, agomelatine has favorable efficacy and tolerability. In particular, it demonstrates superior effects on sleep and alertness and an absence of sexual dysfunction, making it a useful alternative for the treatment of MDD.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, University Health Network, University of Toronto, EN8-222, 200 Elizabeth Street, Toronto, ON, M5G2C4, Canada

    Sidney H. Kennedy MD, FRCPC

  2. Department of Psychiatry, University Health Network, EN8-222, 200 Elizabeth Street, Toronto, ON, M5G2C4, Canada

    Franca M. Placenza PhD

Authors
  1. Sidney H. Kennedy MD, FRCPC
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  2. Franca M. Placenza PhD
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Corresponding author

Correspondence to Sidney H. Kennedy MD, FRCPC .

Editor information

Editors and Affiliations

  1. Sri Sathya Sai Medical Educational and Research Foundation, An International Medical Sciences Research Center, Coimbatore, Tamil Nadu, India

    V. Srinivasan

  2. Department of Obstetrics and Gynecology, Hadassah Hebrew-University Medical Center, Jerusalem, Israel

    Amnon Brzezinski

  3. Department of Physiology, Gulhane Military Medical Academy, Ankara, Turkey

    Sukru Oter

  4. Department of Psychiatry Behavioral Sciences, Mercer University School of Medicine, Macon, Georgia, USA

    Samuel D. Shillcutt

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Kennedy, S.H., Placenza, F.M. (2014). Agomelatine in Depressive Disorders. In: Srinivasan, V., Brzezinski, A., Oter, S., Shillcutt, S. (eds) Melatonin and Melatonergic Drugs in Clinical Practice. Springer, New Delhi. https://doi.org/10.1007/978-81-322-0825-9_19

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  • DOI: https://doi.org/10.1007/978-81-322-0825-9_19

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  • Publisher Name: Springer, New Delhi

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  • Online ISBN: 978-81-322-0825-9

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