Agomelatine: pharmacological profile, possible application, advantages

Abstract

Agomelatine is an antidepressant with a unique pharmacological action that is both a melatonin agonist and a selective serotonin antagonist. The drug's unique pharmacological profile includes the properties of a dual 5-HT2С receptor antagonist as well as the properties of a melatonin MT1 and MT2 receptor agonist. Through its effect on melatonin receptors, agomelatine resynchronizes disturbed circadian rhythms and has a positive effect on sleep architecture. In addition, agomelatine shows a novel and fundamentally different mechanism of anxiolytic action compared to other classes of drugs used to treat anxiety. The article presents studies of agomelatine that demonstrate good treatment results in terms of response rates and remission in major depressive disorder of varying severity and generalized anxiety disorder. Agomelatine in a daily dose of 25–50 mg not only reduces the degree of anhedonia, apathy, anxiety, reduces somatic symptoms of depressive and anxiety disorders, but is also well tolerated, normalizes sexual dysfunctions in patients in psychiatric and general medical networks, it is used in cardiovascular, neurological diseases, and post-COVID-19.