title: The melatonergic system in mood and anxiety disorders and the role of agomelatine: implications for clinical practice.
abstract: Melatonin exerts its actions through membrane MT1/MT2 melatonin receptors, which belong to the super family of G-protein-coupled receptors consisting of the typical seven transmembrane domains. MT1 and MT2 receptors are expressed in various tissues of the body either as single ones or together. A growing literature suggests that the melatonergic system may be involved in the pathophysiology of mood and anxiety disorders. In fact, some core symptoms of depression show disturbance of the circadian rhythm in their clinical expression, such as diurnal mood and other symptomatic variation, or are closely linked to circadian system functioning, such as sleep-wake cycle alterations. In addition, alterations have been described in the circadian rhythms of several biological markers in depressed patients. Therefore, there is interest in developing antidepressants that have a chronobiotic effect (i.e., treatment of circadian rhythm disorders). As melatonin produces chronobiotic effects, efforts have been aimed at developing agomelatine, an antidepressant with melatonin agonist activity. The present paper reviews the role of the melatonergic system in the pathophysiology of mood and anxiety disorders and the clinical characteristics of agomelatine. Implications of agomelatine in "real world" clinical practice will be also discussed.
authors.affiliation: National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4 Teramo, Italy. dodebera@aliceposta.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Berardis
authors.forename: Stefano
authors.initials: S
authors.lastname: Marini
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.forename: Venkataramanujam
authors.initials: V
authors.lastname: Srinivasan
authors.forename: Felice
authors.initials: F
authors.lastname: Iasevoli
authors.forename: Carmine
authors.initials: C
authors.lastname: Tomasetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valchera
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Perna
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Quera-Salva
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.forename: Massimo
authors.initials: M
authors.lastname: di Giannantonio
mesh_terms: D000081:Acetamides / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D000339:Affect / Q000187:drug effects*; D001008:Anxiety Disorders / Q000188:drug therapy*; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002940:Circadian Rhythm / Q000187:drug effects; D006801:Humans; D008550:Melatonin / Q000378:metabolism*; D010818:Practice Patterns, Physicians'; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D008550:Melatonin; C084711:agomelatine; D009281:Naphthalenes