Melatonergic Drug Ramelteon in Neurotherapeutics

  • Venkataramanujam Srinivasan
  • Rahimah Zakaria
  • Domenico de Berardis
  • Francisco López-Muñoz
  • Mohd Jamil Yaacob
  • Zahiruddin Othman
  • Amnon Brzezinski


Melatonin, the hormone secreted by the pineal gland, plays an important role in sleep induction and sleep maintenance. With the advancement of age, there is a decline in melatonin production, and elderly individuals often complain difficulties in sleep onset, maintenance of sleep-wake rhythm, and poor quality of sleep. Melatonin replacement therapy has been used for treating insomnias but it is not uniformly successful. With the synthesis of melatonergic agonist, ramelteon, a chronohypnotic drug with a higher affinity for MT1 and MT2 melatonergic receptors, treatment of insomnias has become easy, and many clinical studies have attested the efficacy of ramelteon in treating primary insomnia and secondary insomnias associated with neurodegenerative and neurodevelopmental disorders like autistic disorder. Melatonin has been implicated in the pathogenesis of delirium and autism spectrum disorders (ASD) and has been tried for treatment of these disorders. Although found successful in treating these disorders, melatonergic agonist ramelteon is used for treating autistic disorder and delirium where the drug has been found effective in not only alleviating the sleep disorders but also the behavioral problems. A low or abnormal level of melatonin is suggested as one of the main reasons for the lack of communication skill and socialization which are the main symptoms of ASD. Ramelteon has been used for treating rapid eye movement (REM) sleep behavior disorder (RBD) also and is found to be effective in increasing sleep efficiency and reducing the intensity of behavioral symptoms of this disorder. As a chronohypnotic drug, ramelteon ameliorated the symptoms of jet lag by improving the nighttime sleep efficiency and daytime alertness.


Autism Spectrum Disorder Autistic Disorder NREM Sleep Autistic Spectrum Disorder Child Autism Spectrum Disorder Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer India 2016

Authors and Affiliations

  • Venkataramanujam Srinivasan
    • 1
  • Rahimah Zakaria
    • 2
  • Domenico de Berardis
    • 3
    • 4
  • Francisco López-Muñoz
    • 5
    • 6
    • 7
  • Mohd Jamil Yaacob
    • 8
  • Zahiruddin Othman
    • 9
  • Amnon Brzezinski
    • 10
  1. 1.Sri Sathya Sai Medical Educational and Research FoundationInternational Medical Sciences Research Study Center Prasanthi NilayamKovai CoimbatoreIndia
  2. 2.Department of Physiology School of Medical SciencesUniversiti Sains MalaysiaKubang KerianMalaysia
  3. 3.NHS, Department of Mental HealthPsychiatry Service of Diagnosis and Treatment Hospital “G.Mazzini”TeramoItaly
  4. 4.Department of Neurosciences and Imaging and Clinical SciencesUniversity “G.D Annunzio”ChietyItaly
  5. 5.Faculty of Health SciencesCamilo José Cela UniversityMadridSpain
  6. 6.Neuropsychopharmacology UnitHospital 12 de Octubre Research Institute (i+12)MadridSpain
  7. 7.Portucalense Institute of Neuropsychology and Cognitive and Behavioural NeurosciencesPortucalense UniversityPortoPortugal
  8. 8.Department of Psychiatry, Faculty of MedicineAsian Institute of Medicine, Science and TechnologyBedongMalaysia
  9. 9.Department of PsychiatrySchool of Medical Sciences Universiti Sains MalaysiaKubang KerianMalaysia
  10. 10.Department of Obstetrics and Gynecology, Haddasah Medical CenterThe Hebrew UniversityJerusalemIsrael

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