Experience of the antidepressive therapy with valdoxan (agomelatine) in a psychogeriatric unit of the psychiatric hospital

Kalyn, Ya. B.; Сафарова, Т. П.; Yakovleva, O. B.; Sheshenin, V.; Корнилов, В. В.; Шипилова, Е. С.; Гаврилова, С. И.

doi:10.17116/jnevro201511511155-62

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…However, these results must not be overinterpreted as they are based only on the small numbers of patients included in studies of older depressed patients. 40,41 Agomelatine has not been approved for use in the United States. No long-term data on the use of agomelatine in LLD are available and such studies are needed to provide data concerning the tolerability of agomelatine in older patients, including the adverse effect of sedation and a possible increase in liver enzyme values.…”

Section: Key Resultsmentioning

confidence: 99%

“…The melatonergic agonist and 5HT2c-receptor antagonist agomelatine, which was approved for unipolar depression in Europe in 2009 but has not been approved in the United States, was investigated as an antidepressant in elderly people with recurrent MDD in 2 studies. [39][40][41] In a placebo-controlled trial involving 222 patients who were 65 years of age or older, Heun et al 40 found a 6.9% difference in remission rates between the agomelatine and placebo groups after an 8-week-treatment favoring agomelatine, although the difference was not statistically significant. However, agomelatine was found to be effective and well-tolerated in reducing depressive symptoms and to have a good adverse effect profile in the geriatric and comorbid study population.…”

Section: Other Antidepressants Agomelatinementioning

confidence: 99%

“…However, agomelatine was found to be effective and well-tolerated in reducing depressive symptoms and to have a good adverse effect profile in the geriatric and comorbid study population. 40 Kalyn et al 41 conducted a small study with 20 depressed patients (age 60 y and older) who received 42 days of treatment with standard-dose agomelatine. They reported a significant reduction in depressive and anxiety symptoms, good tolerability, and an improvement in anhedonia and cognitive function.…”

Section: Other Antidepressants Agomelatinementioning

confidence: 99%

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Therapy Strategies for Late-life Depression: A Review

Piel

Quante

2023

Journal of Psychiatric Practice

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Background: Depression in the elderly requires different treatment options because therapies that are commonly used for depression in younger patients show different effects later in life. Treatment options for late-life depression (LLD) are summarized in this article. Methods: A literature search in Medline/ PubMed performed in June 2020 identified 83 relevant studies. Results: Pharmacotherapy with selective serotonin reuptake inhibitors can be an effective first-line treatment in LLD, but > 50% of elderly patients do not adequately respond. Switching to other selective serotonin reuptake inhibitors or augmenting with mood stabilizers or antipsychotics is often effective in achieving a therapeutic benefit. Severely depressed patients with a high risk of suicidal behavior can be treated with electroconvulsive therapy. Psychotherapy provides a measurable benefit alone and when combined with medication. Limitations: LLD remains an underrepresented domain in research. Paucity of data concerning the effect of specific therapies for LLD, heterogeneity in the quality of study designs, overinterpretation of results from meta-analyses, and discrepancies between study results and guideline recommendations were often noted. Conclusions: Treating LLD is complex, but there are several treatment options with good efficacy and tolerability. Some novel pharmaceuticals also show promise as potential antidepressants, but evidence for their efficacy and safety is still limited and based on only a few trials conducted to date.

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Section: Key Resultsmentioning

confidence: 99%

Section: Other Antidepressants Agomelatinementioning

confidence: 99%

Section: Other Antidepressants Agomelatinementioning

confidence: 99%

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Therapy Strategies for Late-life Depression: A Review

Piel

Quante

2023

Journal of Psychiatric Practice

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“…Some open evaluations in small populations have suggested a good therapeutic effect in elderly populations. In these studies, 6-12 weeks treatment with agomelatine 25-50mg/day was reported to lead to a significant reduction in depressive symptoms [65][66][67][68]. A double blind placebo controlled trial did not support the efficacy of agomelatine however, this trial lacked assay sensitivity due to a high placebo response rate [69].…”

Section: Agomelatinementioning

confidence: 99%

Antidepressant Treatment of Depression in the Elderly: Efficacy and Safety Considerations

Norman¹

2021

obm neurobiol

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Depression in the elderly is a significant clinical problem which is likely to endure as an ongoing issue as the cohort of individuals aged over 65years continues to increase as a proportion of the total population. While there are a multiplicity of approaches to the treatment of depression, the mainstay for moderate to severe cases is pharmacotherapy. The majority of extant antidepressants have demonstrated efficacy, at least in short term (6-12weeks) clinical evaluations. There is demonstrable efficacy over and above that of placebo in the majority of clinical trials for most agents. Within the classes of antidepressants there is no difference between individual agents, while between classes differences have not been demonstrated consistently. Thus, there appears to be little to choose between the various agents. However, considerations other than efficacy play a role in the choice of an antidepressant for an individual patient. A systematic review of the efficacy of antidepressant agents based on trials in elderly populations is presented. Factors influencing the choice of a medication over and above efficacy are presented along with a brief review of adverse events of particular concern in elderly patients. A considerable proportion of elderly patients have comorbid medical conditions, which may also influence the choice of agent due to drug-drug interaction considerations. A brief overview of interactions likely to influence medication selection is also canvassed. While there is every reason to be optimistic about outcomes in elderly patients, there are still unanswered questions about antidepressant efficacy in this population: effectiveness in long-term treatment and in the population of so-called ‘old-old’ elderly are principal among them.

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“…Case reports suggest a potential of agomelatine as treatment for social anxiety [284] and panic disorders [285]. Kalyn et al [286] assessed therapeutic efficacy, tolerability, and safety of agomelatine in elderly patients observing positive results in depression, anxiety, and anhedonia indicators. On the other hand, anxiolytic action of UCM765 was shown to be mediated by MT 2 receptors [182] and anxiety levels did not alter in MT 2 −/− mice in the EPM [251].…”

Section: Melatoninergic System As a Putative Target For Treating Mmentioning

confidence: 99%

Melatoninergic System in Parkinson’s Disease: From Neuroprotection to the Management of Motor and Nonmotor Symptoms

Mack

Schamne

Sampaio

et al. 2016

Oxidative Medicine and Cellular Longevity

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Melatonin is synthesized by several tissues besides the pineal gland, and beyond its regulatory effects in light-dark cycle, melatonin is a hormone with neuroprotective, anti-inflammatory, and antioxidant properties. Melatonin acts as a free-radical scavenger, reducing reactive species and improving mitochondrial homeostasis. Melatonin also regulates the expression of neurotrophins that are involved in the survival of dopaminergic neurons and reduces α-synuclein aggregation, thus protecting the dopaminergic system against damage. The unbalance of pineal melatonin synthesis can predispose the organism to inflammatory and neurodegenerative diseases such as Parkinson's disease (PD). The aim of this review is to summarize the knowledge about the potential role of the melatoninergic system in the pathogenesis and treatment of PD. The literature reviewed here indicates that PD is associated with impaired brain expression of melatonin and its receptors MT1 and MT2. Exogenous melatonin treatment presented an outstanding neuroprotective effect in animal models of PD induced by different toxins, such as 6-hydroxydopamine (6-OHDA), 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), rotenone, paraquat, and maneb. Despite the neuroprotective effects and the improvement of motor impairments, melatonin also presents the potential to improve nonmotor symptoms commonly experienced by PD patients such as sleep and anxiety disorders, depression, and memory dysfunction.

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Experience of the antidepressive therapy with valdoxan (agomelatine) in a psychogeriatric unit of the psychiatric hospital

Abstract: Valdoxan can be recommended for treatment of mild and moderate depression in inpatients of psychiatric hospitals.

Cited by 6 publications

References 8 publications

Therapy Strategies for Late-life Depression: A Review

Therapy Strategies for Late-life Depression: A Review

Antidepressant Treatment of Depression in the Elderly: Efficacy and Safety Considerations

Melatoninergic System in Parkinson’s Disease: From Neuroprotection to the Management of Motor and Nonmotor Symptoms

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