University of Toronto, Human Biology , Toronto, ON , Canada.
Expert Opin Pharmacother. 2014 Feb;15(2):259-74. doi: 10.1517/14656566.2014.862233. Epub 2013 Dec 16.
Agomelatine is a novel antidepressant that acts as a melatonin MT1 and MT2 receptor agonist and serotonin 5-HT2C receptor antagonist, putatively reversing circadian rhythm disruption in major depressive disorder (MDD) and promoting dendritic neurogenesis in animal models of depression. It may be a preferable alternative to antidepressants currently in use due to its improved tolerability profile.
The PubMed database was searched for published randomized controlled trials (RCTs) evaluating the efficacy of agomelatine as well as its tolerability and safety in the treatment of MDD. The key search term used was agomelatine combined with major depressive disorder/depressive disorder/depression and antidepressant. Article selection was based upon sample size and overall methodological quality.
Agomelatine is a multi-modal agent with novel mechanisms of action, having sound evidence supporting its overall statistical efficacy and adequate tolerability profile for MDD treatment. However, the clinical significance of agomelatine has been contested, calling for additional studies in evaluation of its effect size. Of further concern are reported transient elevations in transaminases and severe but rare liver reactions.
阿戈美拉汀是一种新型抗抑郁药，作为褪黑素 MT1 和 MT2 受体激动剂和 5-羟色胺 5-HT2C 受体拮抗剂，推测可逆转重度抑郁症（MDD）的昼夜节律紊乱，并促进抑郁动物模型中的树突神经发生。由于其改善的耐受性特征，它可能是目前使用的抗抑郁药的更好替代品。
检索 PubMed 数据库中评估阿戈美拉汀治疗 MDD 的疗效及其耐受性和安全性的已发表随机对照试验（RCT）。使用的关键搜索词是阿戈美拉汀联合重度抑郁症/抑郁症/抑郁和抗抑郁药。根据样本量和整体方法学质量选择文章。
阿戈美拉汀是一种具有新型作用机制的多模式药物，具有支持其整体统计学疗效的充分证据，并且对 MDD 治疗具有足够的耐受性特征。然而，阿戈美拉汀的临床意义受到质疑，需要进一步研究评估其疗效。更令人担忧的是报告的转氨酶短暂升高和严重但罕见的肝脏反应。
