Agomelatine.: Antidepressant, treatment of bipolar disorder, melatonin agonist/5-HT2C antagonist.

Agomelatine is a metabolically stable analogue of melatonin that is known to act as a selective and specific agonist at melatonin receptor sites in the hypothalamus. Agomelatine has also been shown to act as a competitive antagonist at serotonin receptors, giving it the novel pharmacological profile of a MASSA (Melatonin Agonist and Selective Serotonin Antagonist). Its ability to mimic the action of melatonin means that it is a potential candidate for the treatment of disorders characterized by dysfunction of biological rhythms (e g., sleep disorders/depression). A recent randomized, controlled trial has shown that agomelatine 25 mg/day is as effective as paroxetine in the treatment of patients with major depressive disorder and bipolar disorder, yet exhibits a more favorable tolerability profile than the traditional antidepressant in this, group. Agomelatine, therefore, holds great promise for use as an antidepressant drug with a unique mode of action and is currently undergoing further clinical investigation.