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July 2, 2005

Melatonin Agonist For Bipolar Disorder

A melatonin agonist may be able to treat those suffering from bipolar disorder. Agomelatine (Valdoxan) is the first melatoninergic antidepressant and it has been shown to be effective in treating major depressive disorder. This has led researchers to the conclusion that it might be useful in treating bipolar disorder.

"The new agent works on the melatonin 1 and melatonin 2 receptors and also has 5-HT2c antagonist properties, as do selective serotonin reuptake inhibitors (SSRIs), said Dr. Calabrese, a professor of psychiatry, at Case Western Reserve University, Cleveland, Ohio. He added that the hope is that a melatoninergic agent would be less likely to cause hypomania and rapid cycling than are SSRIs" (

Ideally, this drug would be used along with a mood stabilizer. It has been sent to the European Agency for the Evaluation of Medical Products, and is expected to be approved by early to mid-2006.

21 patients with bipolar I disorder who were having a major depressive episode were used in this study. They were given agomelatine along with a mood stabilizer. The patients depression was measured by the Hamilton Rating Scale for Depression-17 (HAM-D17). All of the patients used had an initial measure of at least 18. A reduction in their symptoms was defined as a 50% reduction in their original score. Remission was defined as a score of 6 or below on the HAM-D17.

"All patients received 0.25 mg of agomelatine daily during an initial six-week acute period, in which 47% of patients responded during the first week of treatment, and in which 85% had responded by the end of the acute phase. Afterward, 19 patients continued for an extension phase from weeks 6 to 52; 11 patients completed the study. Among those who continued, 10 were in remission by the end of the study. Among the eight discontinuations, two were for lack of efficacy, three were for adverse events, and of the remaining three, one had recovered by week 18 and did not feel the need for ongoing therapy, one had withdrawn consent, and one had poor compliance. Fifteen adverse events occurred, including two manic or hypomanic episodes" (

Although the results look promising, agomelatine most be studied further before it can be concluded that it is effective in treating bipolar disorder.

The source of this article was Medscape at:

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