Agomelatine in depression

Expert Opin Drug Saf. 2013 Nov;12(6):873-80. doi: 10.1517/14740338.2013.828690. Epub 2013 Sep 16.

Abstract

Introduction: Agomelatine is a relatively new antidepressant with a mechanism of action that is different from other antidepressants: it is a melatonergic agonist and a 5-HT2C antagonist. It is an effective treatment for depression, with relatively mild side effects. It may be a valuable pharmacological alternative in the clinical approach on depression.

Areas covered: The literature about agomelatine has been comprehensively reviewed. Agomelatine's efficacy, safety and tolerability are reviewed based on the studies undertaken in patients with major depressive disorder (MDD) and bipolar disorder (BPD).

Expert opinion: Agomelatine has shown an antidepressant effect in preclinical models, and the results of a large-scale clinical trial program, conducted in MDD, indicate both an antidepressant activity and a favorable tolerability profile. Agomelatine has no discontinuation syndrome, sexual discomfort is rare, and it is generally weigh neutral. The drug appears to be relatively safe in case of overdose. However, some cases of elevated hepatic transaminases are reported during treatment. As agomelatine has a mechanism of action that differs from other agents, it may represent a valuable additional treatment option in those patients who do not respond fully or who do not tolerate the side effects of other antidepressants.

Publication types

  • Review

MeSH terms

  • Acetamides / adverse effects
  • Acetamides / pharmacology
  • Acetamides / therapeutic use*
  • Animals
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use*
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / physiopathology
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / physiopathology
  • Humans
  • Melatonin / agonists
  • Serotonin 5-HT2 Receptor Antagonists / adverse effects
  • Serotonin 5-HT2 Receptor Antagonists / pharmacology
  • Serotonin 5-HT2 Receptor Antagonists / therapeutic use
  • Treatment Outcome

Substances

  • Acetamides
  • Antidepressive Agents
  • Serotonin 5-HT2 Receptor Antagonists
  • agomelatine
  • Melatonin