Melatonin, Sleep, Circadian Rhythm, and Mood Disorders

  • Venkataramanujam Srinivasan
  • Domenico de Berardis
  • Michele Fornaro
  • Francisco López-MuñozEmail author
  • Timo Partonen
  • Rahimah Zakaria


Sleep disturbances and disruptions of circadian rhythms are underlying factors in most mood disorders like major depressive disorder (MDD) and bipolar disorder (BD) and their seasonal pattern or seasonal affective disorder (SAD). Decreases in sleep efficiency, total sleep time, and sleep quality have all been documented in MDD. In addition to this, depressed patients of all these three categories (MDD, BD, SAD) exhibit profound disturbances in circadian rhythms including the sleep-wake rhythm. Circadian clock dysregulation has been suggested to be due to abnormal circadian rhythmicity of gene expression. In particular, CRY1 and CRY2 polymorphisms have been shown to be associated with MDD. Similarly, variations in CRY2, PER2, ARNTL, and NPAS2 are associated with SAD. An antidepressant that benefits sleep quality and resynchronizes disrupted circadian rhythms will be most useful in treating mood disorders. In this context, the newly introduced melatonergic antidepressant agomelatine with MT1 and MT2 agonistic properties with 5-HT2C antagonism has been documented to be beneficial, as it improves sleep, resynchronizes the disrupted circadian rhythms, and elevates mood. This drug also manifests with fewer adverse effects and is emerging as an effective antidepressant.


Insomnia Sleep Clock genes Circadian rhythms Mood disorders Agomelatine 


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Copyright information

© Springer India 2016

Authors and Affiliations

  • Venkataramanujam Srinivasan
    • 1
  • Domenico de Berardis
    • 2
    • 3
  • Michele Fornaro
    • 4
    • 5
  • Francisco López-Muñoz
    • 6
    • 7
    • 8
    Email author
  • Timo Partonen
    • 9
  • Rahimah Zakaria
    • 10
  1. 1.Sri Sathya Sai Medical Educational and Research FoundationInternational Medical Sciences Research Study Center “Prasanthi Nilayam”Kovai CoimbatoreIndia
  2. 2.NHS, Department of Mental HealthPsychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”TeramoItaly
  3. 3.Department of Neurosciences and Imaging and Clinical SciencesUniversity “G. D’Annunzio”ChietiItaly
  4. 4.Department of Education ScienceUniversity of CataniaCataniaItaly
  5. 5.Polyedra Clinical GroupTeramoItaly
  6. 6.Faculty of Health SciencesCamilo José Cela UniversityMadridSpain
  7. 7.Neuropsychopharmacology UnitHospital 12 de Octubre Research Institute (i+12)MadridSpain
  8. 8.Portucalense Institute of Neuropsychology and Cognitive and Behavioural NeurosciencesPortucalense UniversityPortoPortugal
  9. 9.Department of Mental Health and Alcohol ResearchNational Public Health Institute, National Institute for Health and WelfareHelsinkiFinland
  10. 10.Department of Physiology, School of Medical SciencesUniversiti Sains MalaysiaKubang KerianMalaysia

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