Agomelatine treatment of major depressive disorder
by
Dolder CR, Nelson M, Snider M.
School of Pharmacy,
Wingate University, Wingate, NC 28174, USA.
cdolder@wingate.edu.
Ann Pharmacother. 2008 Dec;42(12):1822-31.


ABSTRACT

OBJECTIVE: To review the efficacy, safety, pharmacologic, and pharmacokinetic data of agomelatine to better understand its potential role in the treatment of patients with major depressive disorder. DATA SOURCES: A MEDLINE search (1966-October 2008) was conducted using the following terms: agomelatine, antidepressant, S20098, melatonin, serotonin, 5-HT(2C), MT, efficacy, safety, adverse effect, pharmacology, pharmacokinetic, receptor binding, depression, major depressive disorder, and mood disorder. STUDY SELECTION AND DATA EXTRACTION: All articles in English identified from the data sources were evaluated. Randomized, controlled trials involving humans were prioritized in the review. The references of published articles identified in the initial search process were also examined for any additional studies appropriate for the review. DATA SYNTHESIS: Agomelatine, a potent agonist at type 1 and 2 melatonin receptors, selectively inhibits serotonin. It is extensively metabolized via cytochrome P450 isoenyzmes 1A1, 1A2, and 2C9 to metabolites with less activity than the parent drug. Five randomized controlled studies were identified that examined the efficacy and safety of agomelatine in major depressive disorder. In general, agomelatine was found to produce significant improvements in depressive symptoms compared with placebo on many, but not all, rating scales. Three of the trials had active comparator arms (ie, venlafaxine, paroxetine). In these 3 investigations, agomelatine produced effects on depressive symptoms similar to those of the comparator drugs. A small number of studies have demonstrated sleep benefits with the use of agomelatine in depressed patients. Positive findings also exist for the use of agomelatine in seasonal affective disorder and bipolar depression. The most common adverse effects reported with agomelatine use were headache, nasopharyngitis, and gastrointestinal complaints. The magnitude of agomelatine-related adverse effects appears to be at least similar to some currently marketed antidepressants. CONCLUSIONS: Overall, agomelatine is a promising and well-tolerated medication for the treatment of major depressive disorder. More large-scale controlled trials are needed to gain a better understanding of the relative efficacy and safety of agomelatine.
5-HT2c
Valdoxan
Serotonin
Melatonin
Agomelatine
Agomelatine trials
Agomelatine: structure
Serotonin 5-HT2c receptors
Agomelatine (Valdoxan): review
Agomelatine, stress and memory
Agomelatine (Valdoxan): efficacy and tolerance profile
Agomelatine, 5-HT2c antagonist and melatonin agonist
Agomelatine (Valdoxan, Melitor, Thymanax) and melatonergic drugs
Agomelatine (Valdoxan) and the serotonin 5-HT2b and 5-HT2c receptors
Jet lag: therapeutic use of melatonin and possible application of melatonin analogs


Refs
and further reading

HOME
HedWeb
Nootropics
Cocaine.org
Future Opioids
BLTC Research
MDMA/Ecstasy
Superhapiness?
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family