Agomelatine is sold in Germany under the name Valdoxan® and has only been on the market for a few years. It is a melatonin receptor agonist, which is mainly used in mild to severe depression and can also combat chronic sleep disorders within a certain range.

What is agomelatine?

Agomelatine promotes the release of norepinephrine or serotonin and also leads to increased dopamine production. This combats depression at the chemical level.

Agomelatine promotes the release of monoamines such as noradrenaline or serotonin and also leads to increased dopamine production.

This combats depression at the chemical level, while at the same time creating the side effect of a more comfortable night's sleep in patients suffering from sleep disorders. It is taken orally before going to bed with some water and is subject to a prescription in Germany.

Pharmacological action

Agomelatine comes from the group of melatonin receptor agonists. It works directly against a lack of serotonin or norepinephrine, both of which are considered monoamines.

The clinical depression, which is mainly caused by a deficiency of these two monoamines, should be controlled by agomelatine. In order to increase the production of these neurotransmitters in the body, agomelatine is used: It combats the deficiency syndrome and also leads to an increased release of dopamine. In certain areas of the brain, serotonin, dopamine and norepinephrine are released, which is intended to improve the mood of the patient.

Furthermore, agomelatine is said to have a sleep-promoting effect, so it should always be taken immediately before bedtime. In very small doses, it is therefore also prescribed as a sleep aid when other, widely known as effective means should fail. Since the use of agomelatine also affects the liver, the preparation should not be taken in known liver dysfunction or disease.

It is also unlikely that you will take agomelatine during or immediately after pregnancy, as the active ingredients may enter your breast milk. The average daily dose is 25 milligrams, the maximum dose of 50 milligrams must not be exceeded.

Medical application & use

In Germany, agomelatine is mainly used to treat depression in adults (major depression). Since it is chemically based on a different mode of action than already established drugs, it is often given to people who do not respond to classical treatment. Furthermore, agomelatine is also used in chronic insomnia, but there in lower doses and only then, if there are no contraindications with other drugs.

Since this is a very young drug, there are only a few studies on the effects of agomelatine. In a study with a total of 5, 800 patients, agomelatine outperformed placebo. However, no differences were noted in other three studies when co-administered fluoxetine or paroxetine.

Agomelatine has been used as part of these trials in patients with mild to moderate and severe depression. The success rate was 60 to 70%. At the same time, an improvement in sleep quality was noted in all participants in the studies, with no loss of attention during the day. In seniors with dementia agomelatine should not be used.

Risks & Side Effects

Agomelatine can negatively affect the energy balance of the organism, which is characterized, among other things, by fatigue and persistent drowsiness. Furthermore, agomelatine can cause insomnia as well as headaches and migraine attacks.

In addition, sudden onset of anxiety and dizziness are unlikely, so it is foreseen to operate after the first use of agomelatine heavy machinery. The digestive tract can also be affected by the drug, nausea, constipation and diarrhea are complained of. Increased liver values ​​as well as back pain and occasional blurred vision are some of the side effects of agomelatine.

Very rare side effects include, but are not limited to, sudden hepatitis, as well as suicidal behavior or suicidal thoughts, which runs counter to the original effect of the drug. In particular, due to the elevated liver values, regular functional tests of this organ are recommended when administering agomelatine. It should not be administered if medications such as fluvoxamine or ciprofloxacin are taken at the same time. Tags: 

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