Melatonergic agents influence the sleep-wake and circadian rhythms in healthy and psychiatric participants: a systematic review and meta-analysis of randomized controlled trials

Moon, Eunsoo; Partonen, Timo; Beaulieu, Serge; Linnaranta, Outi

doi:10.1038/s41386-022-01278-5

Cited by 18 publications

(9 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The improvement that we obtained in the actigraphic TST with a low dose of aMT was previously corroborated by studies using objective and subjective sleep measures, such as those by Zhdanova et al [52] and Eckerberg et al [62]. More striking was that the SOL barely changed in our study, as this finding does not support prior evidence stating that low doses of aMT (≤1 mg) may be more effective at initiating sleep and reducing the SOL [63]. However, higher doses of aMT would show more soporific effects and act on the TST more specifically [63,64].…”

Section: Discussionsupporting

confidence: 49%

Low Doses of Melatonin to Improve Sleep in Children with ADHD: An Open-Label Trial

et al. 2023

View full text Add to dashboard Cite

Objective. Only a few studies assessing the sleep effects of low doses of melatonin (aMT) have been performed in the past, most of them in adults, and only one in subjects with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to provide evidence of the changes induced by aMT doses as low as 1 mg in the sleep pattern of pediatric patients with ADHD under treatment with methylphenidate (MPH). Methods. Children and adolescents (7–15 years) with ADHD who were receiving extended-release MPH were recruited. A seven-week sleep diary was collected prior to starting a four-week treatment with 1 mg of aMT (30 min before bedtime). Seven-day actigraphic assessments of sleep were performed before and after treatment. Results. Twenty-seven patients (17 males, 62.96%) participated in the study, who had been receiving MPH for 1.57 (1.11) months. A significant increase in sleep duration (TST) was observed after one month of treatment (463 (49) min to 485 (41) min; p < 0.040), with nonsignificant improvements in sleep-onset latency (SOL), nocturnal awakenings, or sleep efficiency. Only minor adverse effects were reported. Conclusion. Low doses of melatonin (1 mg) are able to increase TST in children and adolescents with ADHD receiving treatment with psychostimulants, with an adequate tolerability profile. Further placebo-controlled trials adjusting the time of aMT administration to the individual circadian profile should explore the effects of low doses of this hormone to shorten SOL in this population of patients.

show abstract

Section: Discussionsupporting

confidence: 49%

Low Doses of Melatonin to Improve Sleep in Children with ADHD: An Open-Label Trial

et al. 2023

View full text Add to dashboard Cite

show abstract

“… 22 , 110 , 165 , 166 Hence, to answer the question of whether – and by which mechanisms – a positive influence of agomelatine upon sleep and daily cycles putatively contributes to its relief of GAD, dedicated studies in patients will be required. 22 , 28 , 165 , 167 …”

Section: General Discussion: Open Questions and Perspectivesmentioning

confidence: 99%

“…22,110,165,166 Hence, to answer the question of whether -and by which mechanisms -a positive influence of agomelatine upon sleep and daily cycles putatively contributes to its relief of GAD, dedicated studies in patients will be required. 22,28,165,167 TherapeuTic advances in psychopharmacology Fourth, since agomelatine has only been evaluated in adult populations for the relief of GAD, it would be of interest to examine its potentially beneficial influence on GAD in specific populations like the young, including children and adolescents. Finally, in view of positive results in tests of social interaction in rodents 48 and the social dimension of GAD, 164 clinical studies of Social Anxiety Disorder and specific types of social phobia would be of interest Finally, agomelatine is currently the only clinically authorized compound to possess a co-joint 5-HT 2C receptor antagonist plus MT 1 /MT 2 agonist profile.…”

Section: Relationship Of the Anxiolytic Properties Of Agomelatine To ...mentioning

confidence: 99%

Agomelatine for the treatment of generalized anxiety disorder: focus on its distinctive mechanism of action

Millan

2022

Therapeutic Advances in Psychopharmacology

View full text Add to dashboard Cite

Generalized anxiety disorder (GAD), the most frequently diagnosed form of anxiety, is usually treated by cognitive-behavioural approaches or medication; in particular, benzodiazepines (acutely) and serotonin or serotonin/noradrenaline reuptake inhibitors (long term). Efficacy, compliance, and acceptability are, however, far from ideal, reinforcing interest in alternative options. Agomelatine, clinically employed in the treatment of major depression, expresses anxiolytic properties in rodents and was effective in the treatment of GAD (including severely ill patients) in several double-blind, short-term (12 weeks) and relapse-prevention (6 months) studies. At active doses, the incidence of adverse effects was no higher than for placebo. Agomelatine possesses a unique binding profile, behaving as a melatonin (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist, yet recognizing neither monoamine transporters nor GABAA receptors. Extensive evidence supports a role for 5-HT2C receptors in the induction of anxious states, and their blockade likely plays a primary role in mediating the anxiolytic actions of agomelatine, including populations in the amygdala and bed nucleus of stria terminalis, as well as the hippocampus. Recruitment of MT receptors in the suprachiasmatic nucleus, thalamic reticular nucleus, and hippocampus appears to fulfil a complimentary role. Downstream of 5-HT2C and MT receptors, modulation of stress-sensitive glutamatergic circuits and altered release of the anxiogenic neuropeptides, corticotrophin-releasing factor, and vasopressin, may be implicated in the actions of agomelatine. To summarize, agomelatine exerts its anxiolytic actions by mechanisms clearly distinct from those of other agents currently employed for the management of GAD. Plain Language Summary How agomelatine helps in the treatment of anxiety disorders Introduction: • Anxiety disorders have a significant negative impact on quality of life. • The most common type of anxiety disorder, called generalized anxiety disorder (GAD), is associated with nervousness and excessive worry. • These symptoms can lead to additional symptoms like tiredness, sleeplessness, irritability, and poor attention. • GAD is generally treated through either cognitive-behavioural therapy or medication. However, widely used drugs like benzodiazepines and serotonin reuptake inhibitors have adverse effects. • Agomelatine, a well-established antidepressant drug, has shown anxiety-lowering (‘anxiolytic’) properties in rats and has been shown to effectively treat GAD with minimal side effects. • However, exactly how it acts on the brain to manage GAD is not yet clear. • Thus, this review aims to shed light on agomelatine’s mechanism of action in treating GAD. Methods: • The authors reviewed studies on how agomelatine treats anxiety in animals. • They also looked at clinical studies on the effects of agomelatine in people with GAD. Results: • The study showed that agomelatine ‘blocks’ a receptor in nerve cells, which plays a role in causing anxiety, called the 5-HT2C receptor. • Blocking this receptor, especially in specific brain regions such as nerve cells of the amygdala, bed nucleus of stria terminalis, and hippocampus, produced the anxiety reduction seen during agomelatine treatment. • Agomelatine also activates the melatonin (MT) receptor, which is known to keep anxiety in check, promote sleep, and maintain the sleep cycle. • Agomelatine should thus tackle sleep disturbances commonly seen in patients with GAD. • Beyond 5-HT2C and MT receptors, signalling molecules in nerve cells that are known to be involved in anxiety disorders (called ‘neurotransmitters’ and ‘neuropeptides’) are also affected by agomelatine. Conclusion: • Agomelatine’s anxiolytic effects are caused by mechanisms that are distinct from those of other medications currently used to treat GAD. • This explains its therapeutic success and minimal adverse side effects.

show abstract

“…The menstrual cycle is the most basic and important circadian rhythm 16 . Melatonin, a hormone secreted by the brain primarily at night, helps maintain the body's biological clock and regulate its rhythm 17 . With a synchronized circadian rhythm in the lungs, heart, kidneys and brain, the immune system can effectively fight off viral infections 18,19 .…”

Section: Introductionmentioning

confidence: 99%

The Concomitant Use of Melatonin and Molnupiravir in the Treatment of COVID-19: Mini Review

Haskologlu

Erdag

Sayıner

et al. 2023

Bangladesh J Med Sci

View full text Add to dashboard Cite

With the ongoing pandemic declared by the World Health Organization,the number of hospitalizations and deaths caused by COVID-19 is increasing dramatically. As new variants of SARS-CoV-2 emerge, new combination therapies are needed to reduce the risk of COVID- 19spreadduring this time of increased transmission risk. In this case, it is vitalto strengthen the immune system against highly inflammatory conditions such as the cytokine storm caused by COVID-19. This brief review highlights the benefits of taking melatonin and the new antiviral drug molnupiravir together in the treatment of COVID-19. Webelieve that this combination therapy against COVID-19 would be of great benefit and should be considered as an adjuvant therapy in the treatment of this disease. Bangladesh Journal of Medical Science Vol. 22 No. 01 January’23 Page : 32-37

show abstract

Melatonergic agents influence the sleep-wake and circadian rhythms in healthy and psychiatric participants: a systematic review and meta-analysis of randomized controlled trials

Cited by 18 publications

References 113 publications

Low Doses of Melatonin to Improve Sleep in Children with ADHD: An Open-Label Trial

Low Doses of Melatonin to Improve Sleep in Children with ADHD: An Open-Label Trial

Agomelatine for the treatment of generalized anxiety disorder: focus on its distinctive mechanism of action

The Concomitant Use of Melatonin and Molnupiravir in the Treatment of COVID-19: Mini Review

Contact Info

Product

Resources

About