Agomelatine in the treatment of seasonal affective disorder
Pjrek E, Winkler D, Konstantinidis A,
Willeit M, Praschak-Rieder N, Kasper S.
Department of General Psychiatry,
Medical University of Vienna,
Währinger Gürtel 18-20, A-1090, Vienna, Austria.
Psychopharmacology (Berl). 2007 Mar;190(4):575-9


RATIONALE: The novel antidepressant agomelatine acts as a melatonergic (MT(1) and MT(2)) receptor agonist and as a serotonin-2C receptor antagonist. Previous studies showed that agomelatine is able to restore disrupted circadian rhythms, which were implicated in the pathophysiology of seasonal affective disorder (SAD). OBJECTIVES: The aim of this study was to investigate the efficacy and tolerability of agomelatine in the treatment of SAD. MATERIALS AND METHODS: Thirty-seven acutely depressed SAD patients were included in an open study with agomelatine (25 mg/day in the evening) over 14 weeks. Efficacy assessments included the Structured Interview Guide for the Hamilton Depression Rating Scale (SAD version; SIGH-SAD), the Clinical Global Impression of Severity (CGI-S) and Improvement (CGI-I), the Circscreen, a self-rating scale for the assessment of sleep and circadian rhythm disorders, and the Hypomania Scale. RESULTS: Agomelatine led to a progressive and statistically significant decrease of SIGH-SAD, CGI-S, and CGI-I scores from week 2 onward (p < 0.001). Furthermore, scores on the Circscreen improved significantly during the study (p < 0.001). Treatment with agomelatine over 14 weeks yielded a response rate of 75.7% (SIGH-SAD <50% of baseline value) and a remission rate (SIGH-SAD <8) of 70.3% in the intention to treat sample. Scores on the Hypomania Scale were consistently low during the study. Agomelatine showed good overall tolerability: throughout the study only one adverse event (mild fatigue) was related to the study drug. CONCLUSIONS: The results of this study suggest that seasonal depression may be effectively and safely treated with agomelatine.
The role of melatonin
Agomelatine: structure
Serotonin 5-HT2C receptors
Clinical efficacy of agomelatine
New antidepressants: agomelatine
Agomelatine: an anxiolytic antidepressant
Agomelatine (Valdoxan): efficacy and tolerance profile
Agomelatine, 5-hHT2c antagonist and melatonin agonist
Pathophysiology of depression: Role of sleep and the melatonergic system
Jet lag: therapeutic use of melatonin and possible application of melatonin analogs

and further reading

Future Opioids
BLTC Research
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