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Current Molecular Pharmacology

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ISSN (Print): 1874-4672
ISSN (Online): 1874-4702

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Review Article

Agomelatine: An Astounding Sui-generis Antidepressant?

Author(s): Muhammad Naveed, Lian-Di Li, Gang Sheng, Zi-Wei Du, Ya-Ping Zhou, Sun Nan, Ming-Yi Zhu, Jing Zhang* and Qi-Gang Zhou*

Volume 15, Issue 7, 2022

Published on: 31 March, 2022

Article ID: e091221198708 Pages: 19

DOI: 10.2174/1874467214666211209142546

Price: $65

Abstract

Major depressive disorder (MDD) is one of the foremost causes of disability and premature death worldwide. Although the available antidepressants are effective and well tolerated, they also have many limitations. Therapeutic advances in developing a new drug's ultimate relation between MDD and chronobiology, which targets the circadian rhythm, led to a renewed focus on psychiatric disorders. In order to provide a critical analysis about antidepressant properties of agomelatine, a detailed PubMed (Medline), Scopus (Embase), Web of Science (Web of Knowledge), Cochrane Library, Google Scholar, and PsycInfo search was performed using the following keywords: melatonin analog, agomelatine, safety, efficacy, adverse effects, pharmacokinetics, pharmacodynamics, circadian rhythm, sleep disorders, neuroplasticity, MDD, bipolar disorder, anhedonia, anxiety, generalized anxiety disorder (GAD), and mood disorders. Agomelatine is a unique melatonin analog with antidepressant properties and a large therapeutic index that improves clinical safety. Published articles revealed that agomelatine is a melatonin receptors (MT1 and MT2) agonist and 5HT2C receptor antagonist. The effects receptors' on melatonin receptors enable the resynchronization of irregular circadian rhythms with beneficial effects on sleep architectures. In this way, agomelatine is accredited for its unique mode of action, which helps to exert antidepressant effects and resynchronize the sleep-wake cycle. To sum up, an agomelatine has not only antidepressant properties but also has anxiolytic effects.

Keywords: Melatonin analog, agomelatine, mode of action, circadian rhythm, sleep disorders, cognitive function, anxiety, depression, anhedonia.

Graphical Abstract

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