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 for mild to severe depression and can also fight chronic sleep disorders within a certain framework.
What is agomelatine
Agomelatine promotes the release of monoamines such as norepinephrine or serotonin and also leads to increased dopamine production.
This combats depression on a chemical level, and at the same time has the side effect of a more comfortable night's sleep for patients who suffer from insomnia. It is taken orally with a little water before going to bed and requires a prescription in Germany.
Pharmacological effect
Agomelatine comes from the group of melatonin receptor agonists. It works directly against a deficiency in serotonin or norepinephrine, both of which are considered monoamines.
The clinical depression, which is mainly caused by a deficiency of these two monoamines, is to be combated by agomelatine. Agomelatine is used to induce an increased production of these neurotransmitters in the body: It combats the deficiency symptoms and also leads to an increased release of dopamine. Serotonin, dopamine and norepinephrine are released in certain areas of the brain, which should improve the patient's mood.
Agomelatine is also said to have a sleep-promoting effect, which is why it should always be taken directly before going to bed. In very small doses it is therefore also prescribed as a sleep aid when other remedies that are widely known to be effective should fail. Since the intake of agomelatine also affects the liver, the preparation must not be taken in the case of known liver malfunctions or diseases.
Agomelatine should not be taken during pregnancy or immediately afterwards, as the active ingredients can get into 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 against depression in adults (major depression). Since it is chemically based on a different mode of action than established drugs, it is often administered to people who do not respond to conventional treatment. Agomelatine is also used for chronic insomnia, but in lower doses and only when there are no contraindicators with other drugs.
Since it is still a very young drug, there are only a few studies on the effects of agomelatine. In a study with 5,800 participants, agomelatine performed better than placebo preparations. However, no differences were found in a further three studies when fluoxetine or paroxetine were administered concomitantly.
In these studies, agomelatine could be used in patients with only mild, moderate, and severe depression. The success rate there was 60 to 70%. At the same time, an improvement in the quality of sleep was found in all participants in the studies, without any loss of attention during the day. Agomelatine must not be used in seniors with dementia.
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➔ Medicines against depressive moods & to lighten the moodRisks & side effects
Agomelatine can have a negative effect on the energy balance of the organism, which is characterized by tiredness and persistent sleepiness, among other things. Furthermore, agomelatine can cause insomnia as well as headaches and migraines.
Sudden anxiety and dizziness are also unlikely, so do not operate heavy machinery after first taking agomelatine.The digestive tract can also be affected by the drug, complaining of nausea, constipation and diarrhea. Elevated liver values as well as back pain and occasional visual disturbances are among the side effects of agomelatine.
Very rare side effects include sudden hepatitis and suicidal behavior or suicidal ideation, which counteract the original effect of the drug. Regular function tests of this organ are recommended when agomelatine is administered, particularly due to the increased liver values. It must not be given if drugs such as fluvoxamine or ciprofloxacin are taken at the same time.
