Focus on agomelatine

Abstract

Background:

Agomelatine is a novel antidepressant with agonist activity at melatonin receptors (MT₁ and MT₂), and antagonistic effects at the 5HT_2c serotonin receptor.

Scope:

This is a review of current evidence for clinical efficacy and safety, drawn from a literature review using Medline and PsycInfo in 2010 using search terms including agomelatine, melatonergic antidepressant and Valdoxan.

Findings:

Agomelatine has antidepressant properties and from early on in its prescription agomelatine can improve sleep architecture and efficiency. Licensed for the treatment of depression in adults, other potential indications include seasonal affective disorder and anxiety disorders. Early controlled short-term studies of agomelatine as an antidepressant indicate good efficacy and tolerability. There are fewer side effects on sexual health than with SSRI antidepressants. No withdrawal or discontinuation syndrome has yet been observed. Agomelatine is contraindicated in patients with impaired liver function and repeated liver function tests are suggested during prescription.

Conclusion:

Agomelatine is a useful and novel addition to the range of avialble antidepressants. Longer term post-marketing studies as to the effects of chronic exposure are required.

Key words::

• Agomelatine
• Antidepressant
• Depression
• Melatonin
• Sleep

Transparency

Declaration of funding

Professor Green is not in receipt of any grant, salary, educational support or honorarium from any pharmaceutical or associated companies or organisations.

Declaration of financial/other relationships

B.G. has disclosed that he is not in receipt of any grant, salary, educational support or honorarium from any pharmaceutical or associated companies or organisations. CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.