Could agomelatine be the ideal antidepressant?

Abstract

Depressive disorders are a common cause of chronic and recurrent psychiatric dysfunction, constituting the fourth leading cause of global diseases. Depression is associated with a high rate of morbidity and mortality, and is a leading cause of global disability. Despite the effectiveness of most currently available antidepressants, many of them have a number of undesirable side effects. Agomelatine is the first melatonin (MT)₁/MT₂ agonist having 5-hydroxytryptamine (5-HT)_2C and 5-HT_2B antagonist properties and antidepressant activity. Agomelatine is effective in several animal models of depression and anxiety. In addition, three large, multicenter, multinational, placebo-controlled studies and several double-blind, placebo-controlled trials of agomelatine have demonstrated that it is a clinically effective and well-tolerated antidepressant in acute trials. Since currently available antidepressants are not always adequate to cause complete remission of symptoms in severely depressed patients, the superior rate of response achieved with agomelatine in this group of patients underlines its future for clinical use in depressive disorders. In summary, the clinical advantage of agomelatine is attributed to its novel mechanism of action, which helps not only to exert antidepressant action, but also to regulate the sleep–wake rhythm.

Keywords::

• agomelatine
• animal model
• anxiety
• depression
• melatonin
• serotonin receptors
• sleep

Acknowledgements

The authors sincerely acknowledge the enthusiastic and constructive comments of several anonymous reviewers on the earlier draft of this manuscript. Their comments helped us greatly to improve the final revision of this manuscript.

The authors declare that they have no proprietary, financial, professional, nor any other personal interest of any nature or kind in any product or services and/or company that could be construed or considered a potential conflict of interest that might have influenced the views expressed in this manuscript.