Psychiatria pre prax 3/2009

Development of antidepressants: from imipramine to agomelatine

The group of antidepressant drugs is indicated for the treatment of depression but they are also used in other indications (e.g. anxiety disorders). The original classification of antidepressants to the generations was derived from the chronology of their introduction to the clinical practice. After the development of more drugs, the classification according the main mechanism of effect was applied. In newer antidepressants the mechanism of effect is known at the level of their influence on monoamines mediators and it is in consistence with monamine theory of depression. At the recent time, the antidepressant agomelatine with different mechanism of effect has been introduced to the clinical practice. Agomelatine is agonist of melatonin receptors and antagonist of 5-HT2C receptors. It influences a regulation of biological rhythms that are disturbed in patients with depression. In the article the historical development of the first antidepressants is described and data about classification of antidepressants and about the agomelatine as the new option of the treatment of depression are provided.

Keywords: depression, antidepressants, monoamine theory, biological rhythms, agomelatine