Novel melatonin-based therapies: potential advances in the treatment of major depression

< Previous Article Next Article > Volume 378, No. 9791, p621–631, 13 August 2011 New Drug Class Novel melatonin-based therapies: potential advances in the treatment of major depression Prof Ian B Hickie, MDcorrespondencePress enter key for correspondence informationemailPress enter key to Email the author, Naomi L Rogers, PhD Published: 18 May 2011 Article has an altmetric score of 24 DOI: http://dx.doi.org/10.1016/S0140-6736(11)60095-0 showArticle Info Summary Full Text Tables and Figures References Summary Major depression is one of the leading causes of premature death and disability. Although available drugs are effective, they also have substantial limitations. Recent advances in our understanding of the fundamental links between chronobiology and major mood disorders, as well as the development of new drugs that target the circadian system, have led to a renewed focus on this area. In this review, we summarise the associations between disrupted chronobiology and major depression and outline new antidepressant treatment strategies that target the circadian system. In particular, we highlight agomelatine, a melatonin-receptor agonist and selective serotonergic receptor subtype (ie, 5-HT2C) antagonist that has chronobiotic, antidepressant, and anxiolytic effects. In the short-term, agomelatine has similar antidepressant efficacy to venlafaxine, fluoxetine, and sertraline and, in the longer term, fewer patients on agomelatine relapse (23·9%) than do those receiving placebo (50·0%). Patients with depression treated with agomelatine report improved sleep quality and reduced waking after sleep onset. As agomelatine does not raise serotonin levels, it has less potential for the common gastrointestinal, sexual, or metabolic side-effects that characterise many other antidepressant compounds. To read this article in full you will need to make a payment Already registered? Please login. Email/Username: Password: Remember me Log In Forgot password? Register Create a new account The Lancet Choice Access any 5 articles from The Lancet family of journals Full text and PDF access to 5 paywall articles of your choice Valid for 365 days from date of purchase Find out more about The Lancet Choice Payment Options Purchase this article for $31.50 USD Online access for 24 hours PDF version can be downloaded as your permanent record Subscribe to The Lancet Purchase a subscription to gain access to this and all other articles in this journal. Options include: Personal online only subscription Institutional Access Visit ScienceDirect to see if you have access via your institution. Already a print subscriber? Claim online access Have a free trial code? Activate your free trial