[Lights off? Neurobiological and pharmacological aspects of the melatonergic-serotonergic synergism]

Abstract

SSRI antiepressants have been widely used for treating depressive symptoms for more than two decades. Despite their frequent usage, meta-analyses proved that only 20-25% of the patients had achieved long term remission. The introduction and spreading of dual-acting agents increased remission rate, but many of the patients with depressive symptoms still suffer from the disorder due to partial pharmacotherapeutic efficacy. Chronobiological disturbances might play an important role both in the pathophysiology and in the ongoing symptoms of depression. Pathological alterations in the melatonergic system may act as the first, obscure signs of the onset of depression. Agomelatine, a new antidepressive agent may offer new possibilities in the pharmacotherapy of depression, due to its synergistic melatonergic-serotonergic activity.