Focus on agomelatine.

Background: Agomelatine is a novel antidepressant with agonist activity at melatonin receptors (MT(1) and MT(2)), and antagonistic effects at the 5HT(2c) serotonin receptor.

Scope: This is a review of current evidence for clinical efficacy and safety, drawn from a literature review using Medline and PsycInfo in 2010 using search terms including agomelatine, melatonergic antidepressant and Valdoxan.

Findings: Agomelatine has antidepressant properties and from early on in its prescription agomelatine can improve sleep architecture and efficiency. Licensed for the treatment of depression in adults, other potential indications include seasonal affective disorder and anxiety disorders. Early controlled short-term studies of agomelatine as an antidepressant indicate good efficacy and tolerability. There are fewer side effects on sexual health than with SSRI antidepressants. No withdrawal or discontinuation syndrome has yet been observed. Agomelatine is contraindicated in patients with impaired liver function and repeated liver function tests are suggested during prescription.

Conclusion: Agomelatine is a useful and novel addition to the range of avialble antidepressants. Longer term post-marketing studies as to the effects of chronic exposure are required.