Agomelatine: a different antidepressant

Agomelatine is an effective antidepressant, with very good response and remission rates. It has a good safety profile and is well tolerated. Its novelty and difference with other antidepressants lies in its influence on the circadian rhythm.

Agomelatine, also marketed as Valdoxan, It is an antidepressant drug included in the group of psychoanaleptics. It represents a novelty compared to classic antidepressant treatments, due to its effects on the circadian system.

It is indeed, a melatonin analogue, the hormone that intervenes in the natural sleep cycle. This hormone is produced by the pineal gland and carries out different functions in our body, especially regulating the sleep-wake cycle. It is considered the first drug of a new generation of antidepressants called MASSA, Melatonin Antagonist Selective Serotonin Antagonists.

What is it for?

Agomelatine, according to its technical data sheet, It is indicated for the treatment of major depressive episodes in adults.. In these patients, its impact on sleep stands out, since it improves its quality and reduces its latency. It also improves the stability of non-REM sleep.

This is due, as we have said previously, to its influence on the circadian rhythm. Lately, Evidence has been found of the relationship between major depression and desynchronization of circadian rhythmsalthough there is still much to study, since the internal mechanisms of the organism are complex.

Melatonin improves sleep in patients with depression, but, however, has no antidepressant effect As such, it does not influence your mood during the day. However, melatonin agonists, such as agomelatine, with slightly different properties, have been shown to be effective antidepressants.

Therefore, agomelatine is used as an antidepressant in major depressive disorder in adults, with the advantage that improves sleep-wake rhythm disturbances in these patients without causing daytime sedation.

Mechanism of action

Agomelatine It is a melatoninergic agonist, with affinity for the MT1 and MT2 melatonin receptors.. In turn, it is an antagonist of the 5-HT2C serotonin receptors. It also increases the release of dopamine and adrenaline, specifically, in the frontal cortex.

Its antidepressant effects are especially due to its action on melatoninergic and 5-HT2C receptors. It is curious to see that both MT1 and 5-HT2C receptors fluctuate in a circadian manner, regulated by light. Furthermore, antagonism at the 5-HT2C receptor prevents the inhibitory effects of light on melatonin synthesis, increasing its release.

Side effects

It should be noted that agomelatine, By not acting on 5-HT1A, muscarinic and histamine receptors, it lacks the side effects associated with them.such as: sedation, overweight, dry mouth, sexual dysfunction, cardiovascular effects, etc.

The most common adverse reactions in agomelatine treatment are headache, nausea and dizziness. In general, they are mild and transitory, and usually appear in the first two weeks of treatment. Other common side effects in treatment with this drug are:

Anxiety.abnormal dreams.Drowsiness.Insomnia.Diarrhea.Constipation.Abdominal pain.Back pain.Weight gain.Fatigue.

As we can see, many of its side effects are related to sleep and with the influence of agomelatine on the circadian rhythm. As we have said, they are usually temporary effects until the body adapts to the medication. Still, it is worth keeping an eye on them.

In any case, if unwanted effects are detected during treatment with the drug, especially at the beginning, it is advisable to consult a specialist. Antidepressant treatment should not be stopped abruptly or without medical indication..

In conclusion, agomelatine is an effective, novel and promising drug for the future. It is necessary to continue studying it to ensure its longer-term effectiveness and, why not, its possible use in minors.

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