Melatonergic Antidepressant Agomelatine and Its Efficacy in Depressive Disorders

  • Venkataramanujam Srinivasan
  • Domenico de Berardis
  • Michele Fornaro
  • Francisco Lopez-Muñoz
  • Rahimah Zakaria
  • Mohd Jamil Yaacob
  • Zahiruddin Othman


A majority of available antidepressant drugs produce unwanted negative effects on sleep. An ideal antidepressant should mitigate the symptoms of depression with improvement of sleep quality and efficiency. Agomelatine is one of the melatonergic analogues that acts specifically on MT1/MT2 melatonergic receptors and at the same time exhibits 5-HT2C antagonism. It also plays an important role in resetting the desynchronized circadian rhythms and disturbed sleep-wake cycles. It has been shown to be effective in a number of animal models of depression and clinical studies in patients with depressive disorders. Clinical studies undertaken on patients with major depressive disorders (MDD), bipolar depression, and seasonal affective disorder (SAD) have shown that agomelatine is clinically very effective in reducing depressive symptoms. It improved sleep efficiency and resynchronized the disrupted circadian rhythms in some studies. Agomelatine also manifests early onset of action with good tolerability and safety profile comparable to selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) antidepressants. But unlike these drugs, agomelatine does not exhibit adverse effects like worsening of insomnia or sexual problems. Agomelatine stands as a unique choice in antidepressant therapy based upon its diversified actions on various parameters such as (a) improving sleep efficiency, (b) resynchronization of disrupted circadian systems, and (c) enhancing hippocampal dendritic maturation.


Major Depressive Disorder Sleep Quality Major Depressive Disorder Bipolar Depression Seasonal Affective Disorder 
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Copyright information

© Springer India 2016

Authors and Affiliations

  • Venkataramanujam Srinivasan
    • 1
  • Domenico de Berardis
    • 2
    • 3
  • Michele Fornaro
    • 4
    • 5
  • Francisco Lopez-Muñoz
    • 6
    • 7
    • 8
  • Rahimah Zakaria
    • 9
  • Mohd Jamil Yaacob
    • 10
  • Zahiruddin Othman
    • 11
  1. 1.Sri Sathya Sai Medical Educational and Research FoundationInternational Medical Sciences Research Study Center “Prasanthi Nilayam”Kovai CoimbatoreIndia
  2. 2.NHS, Department of Mental HealthPsychiatry Service of Diagnosis and Treatment, Hospital “G. Mazzini”TeramoItaly
  3. 3.Department of Neurosciences and Imaging and Clinical SciencesUniversity “G. D’Annunzio”ChietiItaly
  4. 4.Polyedra Clinical GroupTeramoItaly
  5. 5.Department of Formative SciencesUniversity of CataniaCataniaItaly
  6. 6.Faculty of Health SciencesCamilo José Cela UniversityMadridSpain
  7. 7.Neuropsychopharmacology UnitHospital 12 de Octubre Research Institute (i+12)MadridSpain
  8. 8.Portucalense Institute of Neuropsychology and Cognitive and Behavioural NeurosciencesPortucalense UniversityPortoPortugal
  9. 9.Department of Physiology, School of Medical SciencesUniversiti Sains MalaysiaKubang KerianMalaysia
  10. 10.Department of Psychiatry, Faculty of MedicineAsian Institute of Medicine, Science and TechnologyBedongMalaysia
  11. 11.Department of PsychiatrySchool of Medical Sciences Universiti Sains MalaysiaKubang KerianMalaysia

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