Agomelatine Improves Sleep in a Patient with Fatal Familial Insomnia

Froböse, Teresa; Slawik, Helen; Schreiner, Ralph; Veselý, Z.; Wiegand, M.; Bäuml, J.; Förstl, Hans

doi:10.1055/s-0031-1287778

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…More importantly, our REM, NREM, SE, and TST results were consistent with previous investigations that undertook 8 weeks of escitalopram treatment in depression subjects 36 . The improvement of sleep quality, including TST, SE, and REM, was also observed in the melatonin receptor agonist and serotonergic receptor antagonist, agomelatine 37,38 …”

Section: Discussionsupporting

confidence: 90%

“…36 The improvement of sleep quality, including TST, SE, and REM, was also observed in the melatonin receptor agonist and serotonergic receptor antagonist, agomelatine. 37,38 Third, we confirmed an association between DLMO and HAMD-24 and further suggested that the antidepressant effects of SNP may link to DLMO phase advance. Namely, SNP might regulate rhythm by advancing the secretion phase of melatonin.…”

Section: Discussionsupporting

confidence: 68%

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Sini powder with paroxetine ameliorates major depressive disorder by modulating circadian rhythm: A randomized, double‐blind, placebo‐controlled trial

Zhang

et al. 2022

Journal of Pineal Research

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Circadian rhythm disorder is a significant risk factor for mental diseases, and the recovery of circadian rhythm function has gradually become a signal of effective antidepressant therapy. Sini powder (SNP) is a classical, traditional Chinese formula for depression treatment. However, few clinical reports have been recorded. This randomized, double-blinded, controlled trial (ChiCTR1900022700) aimed to explore the efficacy of SNP on depression via regulating circadian rhythm. In total, 36 patients with major depressive disorder (MDD) were enrolled for 4-weeks medication and 6-weeks follow-up. HAMD-24 score and circadian rhythm index, including dim light melatonin onset (DLMO) and phase angle difference (PAD), were included in the assessment. DLMO and PAD were statistically significant in the SNP group after 4 weeks of treatment (p < .05) and with greater improvement in DLMO (p = .03). In addition, DLMO and the HAMD-24 score showed a positive correlation (p < .05); the HAMD-24 score degree decreased significantly over time (p < .001). Similarly, interaction effects were shown significantly between group and time (p = .049). The duration of SNP supplementation was relatively short, and the sample size was relatively small. SNP granules combined with paroxetine tablets have definite efficacy in improving the circadian rhythms of MDD patients, reflecting the therapeutic advantages of traditional Chinese medicine as antidepressants.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 68%

Sini powder with paroxetine ameliorates major depressive disorder by modulating circadian rhythm: A randomized, double‐blind, placebo‐controlled trial

Zhang

et al. 2022

Journal of Pineal Research

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“…Before its marketing AGM had demonstrated antidepressive eff ects in several animal models of depression and furthermore featured a potential to restore normal circadian rhythms in animal models of a disrupted circadian system [ 6 ] . In line with this there is clinical evidence that AGM improves sleep in familial insomnia [ 21 ] . According to published results of clinical trials AGM had proven superior effi cacy in comparison to placebo [ 22 -26 ] and equivalent effi cacy compared to standard antidepressive agents in the treatment of the acute phase Introduction ▼ Agomelatine (AGM), an acetamide naphthalene analogue of melatonin, was approved by the European Medicines Agency (EMA) for the treatment of major depressive disorder in adults in February 2009 [ 1 ] .…”

supporting

confidence: 62%

Agomelatine and Hepatotoxicity: Implications of Cumulated Data Derived from Spontaneous Reports of Adverse Drug Reactions

et al. 2013

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Considering the antidepressant agomelatine (AGM) there is a discrepancy between the widespread knowledge of the potential of AGM to cause hepatotoxic adverse drug reactions (ADR) and the availability of corresponding published data. This impedes an adequate assessment of the hepatotoxicity profile of AGM. We conducted a query of the database of a German Medical Regulatory Body (BfArM) and analyzed spontaneous reports of hepatotoxic ADR. We identified n=58 cases of AGM-related hepatotoxic ADR. Most frequent ADR was asymptomatic increase of liver enzymes (79%); n=6 patients (10%) with AGM-related toxic hepatitis were reported. Characteristics of patients: female sex (69%), age > 50 years (mean 54 years), polypharmacy (57%), and presence of cardiovascular risk factors (58.5%). Most of the hepatotoxic ADR (90%) were reported to have improved/recovered after discontinuation of AGM. Our evaluation suggests that AGM features a potential to cause severe forms of hepatotoxicity and emphasizes that a pre-existing liver disease is a contraindication for treatment with AGM. Secondly, increased age, female sex and polypharmacy may be risk factors for the development of AGM-related hepatotoxic ADR.

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“…76 In yet another study in a patient with fatal familial insomnia (FFI), agomelatine in a 25-mg dose improved slow sleep and sleep efficiency. 77 …”

Section: Agomelatine In Other Disordersmentioning

confidence: 99%

Agomelatine in Depressive Disorders: Its Novel Mechanisms of Action

Srinivasan¹,

Zakaria²,

Othman³

et al. 2012

JNP

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Disruptions in sleep and sleep-wake cycle regulation have been identified as one of the main causes for the pathophysiology of depressive disorders. The search has been on for the identification of an ideal antidepressant that could improve both sleep disturbances and depressive symptomatology. Melatonin, the major hormone of the pineal gland, has been shown to improve sleep and is involved in the regulation of the sleep-wake cycle. Identification of high concentrations of MT1 and MT2 melatonergic receptors in the suprachiasmatic nucleus of the anterior hypothalamus, the structure concerned with regulation of circadian rhythms and sleep-wake cycles, has led to the development of melatonergic agonists with greater potency and longer durations of action. Agomelatine is one such melatonergic agonist that acts specifically on MT1/MT2 melatonergic receptors and at the same time exhibits 5-HT2C antagonism, a property that is utilized by current antidepressants that are in clinical use. Agomelatine has been shown to be effective in a number of animal models of depression. Clinical studies undertaken on patients with major depression, bipolar disorders, seasonal affective disorder, and generalized anxiety disorder have all shown that agomelatine is also very effective in ameliorating depressive symptoms and manifesting early onset of action with a good tolerability and safety profile. It improved sleep efficiency and also resynchronized the disrupted circadian rhythms. Hence, the melatonergic modulation by agomelatine is suggested as one of the mechanisms for its antidepressant effect. Agomelatine's action on dendritic neurogenesis in animal models of depression is also identified as yet another action.

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Agomelatine Improves Sleep in a Patient with Fatal Familial Insomnia

Cited by 11 publications

References 7 publications

Sini powder with paroxetine ameliorates major depressive disorder by modulating circadian rhythm: A randomized, double‐blind, placebo‐controlled trial

Sini powder with paroxetine ameliorates major depressive disorder by modulating circadian rhythm: A randomized, double‐blind, placebo‐controlled trial

Agomelatine and Hepatotoxicity: Implications of Cumulated Data Derived from Spontaneous Reports of Adverse Drug Reactions

Agomelatine in Depressive Disorders: Its Novel Mechanisms of Action

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