title: Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs.
abstract: Traveling through several time zones results in a constellation of symptoms known as jet lag. These include reduced alertness, daytime fatigue, loss of appetite, reduced cognitive skills, and disruption of the sleep/wake cycle. In susceptible air travel passengers, jet lag may exacerbate affective illness and result in psychiatric morbidity. Dysregulation of circadian rhythms and melatonin secretion represent the common underlying factor in jet lag and other circadian disorders. Recent studies have established the effectiveness of strategically timed administration of melatonin and appropriate timed exposure to environmental schedules including light in counteracting the dysregulation (chronobiologic actions). With the introduction of melatonergic agonists such as ramelteon and tasimelteon, which have both a stronger affinity for MT₁ and MT₂ melatonin receptors and a longer half-life, new therapeutic options now exist for treating the sleep disturbances associated with jet lag. The melatonin analogs are unique inasmuch as they can also enhance daytime alertness. The recently introduced melatonergic antidepressant agomelatine, which has established its supremacy over other antidepressants in having a significant chronobiologic activity, represents a good choice for treating depressive symptoms that are associated with jet lag.
authors.affiliation: Sri Sathya Sai Medical Educational and Research Foundation, Prasanthi Nilayam, Kovai Thirunagar, India.
authors.forename: Venkatramanujam
authors.initials: V
authors.lastname: Srinivasan
authors.forename: Jarnail
authors.initials: J
authors.lastname: Singh
authors.forename: Seithikurippu R
authors.initials: SR
authors.lastname: Pandi-Perumal
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Brown
authors.forename: David Warren
authors.initials: DW
authors.lastname: Spence
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Cardinali
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D001572:Benzofurans / Q000627:therapeutic use; D002492:Central Nervous System Depressants / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007192:Indenes / Q000627:therapeutic use; D020179:Jet Lag Syndrome / Q000150:complications / Q000188:drug therapy*; D008550:Melatonin / Q000819:agonists* / Q000031:analogs & derivatives / Q000627:therapeutic use*; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications / Q000188:drug therapy; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D001572:Benzofurans; D002492:Central Nervous System Depressants; D003521:Cyclopropanes; D007192:Indenes; D008550:Melatonin; C084711:agomelatine; D009281:Naphthalenes; C495910:ramelteon; C478745:tasimelteon