Psychiatria pre prax 6/2009

Mechanism of effect of agomelatine – the innovative approach to the treatment of depression

Agomelatine is the most recently registered antidepressatns with different mechanism of effect in comparison with other currently used antidepressants. It has agonistic properties to MT1 and MT2 melatonin receptors and it antagonizes serotonin 5-HT2C receptors (5-HT = 5-hydroxytryptamine). Activity on melatonin receptors has influence on processes connected with circadian rhythmicity from which the sleep rhythms are most important in depression. The result from antagonistic effect on 5-HT2C receptors is an increase of dopamine and noradrenalin levels in prefrontal cortex. All this properties are transformed to the antidepressive effect of agomelatine. Agomelatine was registered for the treatment of unipolar depression on the ground of clinical documentation from the studies in which the efficacy of agomelatine was demonstrated. In Slovakia the VALID phase IV study is recently in progress. The results from the study will bring about summarized information about the use of agomelatine in common clinical practice.

Keywords: agomelatine, MT1 receptor, MT2 receptor, depression, circadian rhythm