Profile of agomelatine and its potential in the treatment of generalized anxiety disorder
Open accessAbstract
BACKGROUND: Although many generalized anxiety disorder (GAD) patients respond to the available pharmacological treatments, nearly half of them do not present the expected results. Besides, the side effects associated to some drugs have a negative impact on treatment adherence. Therefore, the aim of this review was to report the clinical profile of agomelatine, a selective melatonergic MT1/MT2 receptor agonist with serotonin 5-HT2c receptor antagonist activities, as a potential pharmacological option in the treatment of GAD. METHODS: We performed a literature review regarding studies that evaluated the use of agomelatine in GAD treatment. RESULTS: Two short-term, double-blinded studies and one prevention-treatment trial evaluated the efficacy of agomelatine in the treatment of GAD. Agomelatine was associated with higher rates of clinical response and remission, when compared to placebo. In addition, the long-term use of agomelatine decreased the risk of relapse of anxiety symptoms, even for the severely ill patients. Besides, the tolerability was satisfactory with the absence of discontinuation symptoms, as observed in previous studies. CONCLUSION: The efficacy and tolerability profiles of agomelatine in the treatment of GAD were good. However, the scarce number of trials, the small sample sizes, and the use of patients without any comorbid conditions were some limitations that impaired the generalization of the results in the general population. Nevertheless, agomelatine is an attractive off-label option in the treatment of GAD that needs more conclusive evidences to establish its role in future guidelines.
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Agomelatine's anxiolytic effect seems to be a result of the synergistic action of antagonising 5-HT2C receptors in subcortical areas including hippocampus and MT receptor stimulation enhancing neurogenesis and reducing stress-induced glutamate release.
“Its anxiolytic effect seems to be a result of the synergistic action of this action, antagonising 5-HT 2C receptors in subcortical areas including hippocampus and the MT receptor stimulation enhancing neurogenesis and reducing stress-induced glutamate release (Levitan et al., 2015;Tardito, Molteni, Popoli, & Racagni, 2012).”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Levitan et al., 2015
Agomelatine has been shown to positively affect sleep-related measures including REM and slow wave sleep and the quality of sleep, so it is likely to be particularly useful for anxiety patient populations with sleep-related symptoms including PTSD and OCD.
“Since agomelatine has been shown to positively affect sleep-related measures including REM and slow wave sleep and the quality of sleep (Buoli et al., 2017;Guardiola-Lemaitre et al., 2014;Levitan et al., 2015), it is likely to be particularly useful for anxiety patient populations with sleep-related symptoms including also PTSD and OCD (De Berardis et al., 2015).”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Levitan et al., 2015
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- Authors
- Levitan, M., Papelbaum, M., & E Nardi, A.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Corresponding author
- Levitan, Michelle
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2015-05
- Volume
- 11
- Pages
- 1149
- ISSN
- 1176-6328 (ISSN-L)
- 1178-2021
- PMC
- PMC4427071
- OpenAlex
- W1942827836
- Cited by
- 25
- References
- 40
- Citations by year
- 2026: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2019: 5 · 2018: 1 · 2017: 5 · 2016: 6
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Complementary and alternative medicine › Medicinal Plant Extracts Effects
- Keywords
- agomelatine, generalized anxiety disorder, off-label drug use, treatment efficacy, tolerability, relapse prevention, medication adherence
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