阿戈美拉汀:一种令人惊叹的独特抗抑郁药?

Agomelatine: An Astounding Sui-generis Antidepressant?

机构信息

Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing 211166, P.R. China.

Key Laboratory of Cardiovascular and Cerebrovascular Medicine, School of Pharmacy, Nanjing Medical University, Nanjing 211166, P.R. China.

出版信息

Curr Mol Pharmacol. 2022;15(7):943-961. doi: 10.2174/1874467214666211209142546.

Abstract

Major depressive disorder (MDD) is one of the foremost causes of disability and premature death worldwide. Although the available antidepressants are effective and well tolerated, they also have many limitations. Therapeutic advances in developing a new drug's ultimate relation between MDD and chronobiology, which targets the circadian rhythm, led to a renewed focus on psychiatric disorders. In order to provide a critical analysis about antidepressant properties of agomelatine, a detailed PubMed (Medline), Scopus (Embase), Web of Science (Web of Knowledge), Cochrane Library, Google Scholar, and PsycInfo search was performed using the following keywords: melatonin analog, agomelatine, safety, efficacy, adverse effects, pharmacokinetics, pharmacodynamics, circadian rhythm, sleep disorders, neuroplasticity, MDD, bipolar disorder, anhedonia, anxiety, generalized anxiety disorder (GAD), and mood disorders. Agomelatine is a unique melatonin analog with antidepressant properties and a large therapeutic index that improves clinical safety. Published articles revealed that agomelatine is a melatonin receptors (MT1 and MT2) agonist and 5HT2C receptor antagonist. The effects receptors' on melatonin receptors enable the resynchronization of irregular circadian rhythms with beneficial effects on sleep architectures. In this way, agomelatine is accredited for its unique mode of action, which helps to exert antidepressant effects and resynchronize the sleep-wake cycle. To sum up, an agomelatine has not only antidepressant properties but also has anxiolytic effects.

摘要

重性抑郁障碍(MDD)是全球首要致残和导致早逝的原因之一。尽管现有的抗抑郁药有效且耐受性良好,但它们也存在许多局限性。在开发新药物方面的治疗进展最终将 MDD 与生物钟生物学联系起来,针对昼夜节律,这导致人们重新关注精神疾病。为了对阿戈美拉汀的抗抑郁特性进行批判性分析,我们使用以下关键字在 PubMed(Medline)、Scopus(Embase)、Web of Science(Web of Knowledge)、Cochrane 图书馆、Google Scholar 和 PsycInfo 上进行了详细的搜索:褪黑素类似物、阿戈美拉汀、安全性、疗效、不良反应、药代动力学、药效学、昼夜节律、睡眠障碍、神经可塑性、MDD、双相情感障碍、快感缺失、焦虑、广泛性焦虑障碍(GAD)和情绪障碍。阿戈美拉汀是一种具有抗抑郁特性和较大治疗指数的独特褪黑素类似物,可提高临床安全性。已发表的文章表明,阿戈美拉汀是褪黑素受体(MT1 和 MT2)激动剂和 5HT2C 受体拮抗剂。这些受体的作用使不规则的昼夜节律重新同步,对睡眠结构产生有益影响。通过这种方式,阿戈美拉汀因其独特的作用模式而获得认可,这有助于发挥抗抑郁作用并重新同步睡眠-觉醒周期。总之,阿戈美拉汀不仅具有抗抑郁作用,还有抗焦虑作用。

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