Agomelatine in the treatment of seasonal affective disorder
by
Pjrek E, Winkler D, Konstantinidis A,
Willeit M, Praschak-Rieder N, Kasper S.
Department of General Psychiatry,
Medical University of Vienna,
Währinger Gürtel 18-20, A-1090, Vienna, Austria.
edda.pjrek@meduniwien.ac.at
Psychopharmacology (Berl). 2007 Mar;190(4):575-9

ABSTRACT

RATIONALE: The novel antidepressant agomelatine acts as a melatonergic (MT(1) and MT(2)) receptor agonist and as a serotonin-2C receptor antagonist. Previous studies showed that agomelatine is able to restore disrupted circadian rhythms, which were implicated in the pathophysiology of seasonal affective disorder (SAD). OBJECTIVES: The aim of this study was to investigate the efficacy and tolerability of agomelatine in the treatment of SAD. MATERIALS AND METHODS: Thirty-seven acutely depressed SAD patients were included in an open study with agomelatine (25 mg/day in the evening) over 14 weeks. Efficacy assessments included the Structured Interview Guide for the Hamilton Depression Rating Scale (SAD version; SIGH-SAD), the Clinical Global Impression of Severity (CGI-S) and Improvement (CGI-I), the Circscreen, a self-rating scale for the assessment of sleep and circadian rhythm disorders, and the Hypomania Scale. RESULTS: Agomelatine led to a progressive and statistically significant decrease of SIGH-SAD, CGI-S, and CGI-I scores from week 2 onward (p < 0.001). Furthermore, scores on the Circscreen improved significantly during the study (p < 0.001). Treatment with agomelatine over 14 weeks yielded a response rate of 75.7% (SIGH-SAD <50% of baseline value) and a remission rate (SIGH-SAD <8) of 70.3% in the intention to treat sample. Scores on the Hypomania Scale were consistently low during the study. Agomelatine showed good overall tolerability: throughout the study only one adverse event (mild fatigue) was related to the study drug. CONCLUSIONS: The results of this study suggest that seasonal depression may be effectively and safely treated with agomelatine.

SAD
5-HT2c
Serotonin
Melatonin
Agomelatine
The role of melatonin
Agomelatine: structure
Serotonin 5-HT2C receptors
Clinical efficacy of agomelatine
New antidepressants: agomelatine
Agomelatine: an anxiolytic antidepressant
Agomelatine (Valdoxan): efficacy and tolerance profile
Agomelatine, 5-hHT2c antagonist and melatonin agonist
Pathophysiology of depression: Role of sleep and the melatonergic system
Jet lag: therapeutic use of melatonin and possible application of melatonin analogs