Is Circadian Rhythm Disruption Important in Obsessive-Compulsive Disorder (OCD)? A Case of Successful Augmentation With Agomelatine for the Treatment of OCD

Rocha, Felipe Filardi da; Corrêa, Humberto

doi:10.1097/wnf.0b013e318223421f

Cited by 26 publications

(20 citation statements)

References 11 publications

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“…Furthermore, Monteleone et al [18] reported, in OCD patients, an hyperactivity of the hypothalamic-pituitary-adrenal axis, with an increased secretion of adrenocorticotropic hormone and cortisol and a reduced secretion of melatonin. On the basis of such observations, it is also possible to hypothesize that the restoration of circadian rhythms, such as the improvement of sleep efficiency together with the disappearance of intrasleep awakening, through MT1 and MT2 agonism due to agomelatine augmentation, may have contributed to improve symptomatology confirming the observation of da Rocha and Correa [10]. …”

Section: Discussionsupporting

confidence: 55%

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Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

Berardis

Serroni

Marini³

et al. 2012

Case Reports in Psychiatry

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Obsessive-compulsive disorder (OCD) is a chronic condition characterized by obsessions or compulsions that cause distress or interfere with functioning. Selective serotonin reuptake inhibitors are the first-line strategy in the treatment of OCD, but approximately 40% to 60% of patients with OCD fail to respond to them. Several augmentation strategies have been proposed, including the use of atypical antipsychotics and antidepressant combinations. In the present paper we describe the case of a young female patient suffering from severe treatment-resistant OCD who remitted as a result of agomelatine augmentation of escitalopram therapy.

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Section: Discussionsupporting

confidence: 55%

“…It has been reported that agomelatine may be beneficial in the treatment of OCD, although data are limited mainly to case series [8, 9], with initial observations of some efficacy in treatment resistance [10]. …”

Section: Introductionmentioning

confidence: 99%

Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

Berardis

Serroni

Marini³

et al. 2012

Case Reports in Psychiatry

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“…108 When added to classical pharmacological agents used for OCD (eg, escitalopram, venlafaxine, clomipramine, risperidone, and/or aripiprazole), agomelatine has been found to improve OC symptoms in several cases of treatment-resistant OCD. [109][110][111] In some cases, this led to full remission after ∼3 months of treatment, 109 and in reports with longitudinal monitoring, clinical improvements were often sustained over several months. 110,111 A multiple case study reported considerable clinical improvements in three out of six cases of treatment-resistant OCD.…”

Section: Melatonin Agentsmentioning

confidence: 99%

“…[109][110][111] In some cases, this led to full remission after ∼3 months of treatment, 109 and in reports with longitudinal monitoring, clinical improvements were often sustained over several months. 110,111 A multiple case study reported considerable clinical improvements in three out of six cases of treatment-resistant OCD. 112 Interestingly, two of the three individuals who responded to agomelatine initially presented with sleep disruptions.…”

Section: Melatonin Agentsmentioning

confidence: 99%

Etiopathology and neurobiology of obsessive-compulsive disorder: focus on biological rhythms and chronotherapy

Robillard¹,

Boafo²

2016

CPT

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This review examines biological rhythms in persons with obsessive-compulsive disorder (OCD) and their potential relevance to the pathophysiology and treatment of this disorder. In some cases of OCD, the expression of affective, cognitive, and behavioral symptoms may be influenced by circadian and seasonal rhythms, and this could possibly interact with other neurophysiological factors. Further work is required to characterize circadian profiles linked to OCD, but findings thus far highlighted delays in both the sleep-wake cycle and melatonin secretion, as well as reduced circadian rhythmicity of body temperature. It is proposed that these changes in behavioral and endogenous rhythms may increase one's vulnerability to obsessivecompulsive symptoms. Accordingly, obsessive-compulsive symptoms appear to be more severe in individuals with lower circadian amplitude and often worsen in the afternoon and evening. An increasing number of studies reported encouraging outcomes following the integration of sleep and circadian-based treatments in the management of OCD. There is a need for larger controlled trials evaluating the efficacy of chronotherapies in the context of OCD.

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“…Moreover, in the literature there is a case report of social anxiety disorder effectively treated with agomelatine monotherapy 114 and some reports of agomelatine efficacy in obsessive compulsive disorder both in monotherapy 115,116 and in augmentation. 117 However, well performed studies on these disorders are still lacking.…”

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confidence: 99%

The melatonergic system: effects on sleep and implications for the treatment of psychiatric disorders

Berardis¹

2011

CPT

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The circadian pacemaker or biological clock, located in the hypothalamic suprachiasmatic nucleus, is the generation site of circadian rhythms. The light/dark cycle is the circadian pacemaker's dominant synchronizing agent, though it is also influenced by neurotransmitters and the phase-shifting effects of various chemical and pharmacological components, of which melatonin (N-acetyl-5-methoxytryptamine) is the most well established. In recent years, melatonin and melatonin analogs have been commercialized in many countries, mainly with hypnotic purposes. A new compound, agomelatine, has been recently synthesized and studied. Among melatonin analogs, this drug possesses unique pharmacological and clinical features; it is an antagonist at 5-HT2B and 5-HT2C receptors and has well established antidepressant and anxiolytic properties. Agomelatine opens new perspectives in the chronobiotic treatment of depression. The purpose of the present review was to elucidate the effects of the melatonergic system on sleep and the implications for the treatment of psychiatric disorders. Introduction: circadian and sleep-wake systemsMany biological functions are regulated by biological rhythms, among which circadian rhythms (Latin: circa, about; dies, day) are the most extensively studied and the best understood. They determine daily rhythmicity in behavior, core body temperature, sleep, feeding, drinking, and hormonal levels. 1,2 These circadian rhythms prepare the organism to anticipate daily changes in the environment and are not simply driven by the 24-hour environmental cycle, since they persist in the absence of time cues. 3 The circadian pacemaker, or biological clock, is the generation site of circadian rhythms. In mammals, the biological clock is located in the suprachiasmatic nucleus (SCN) of the anterior hypothalamus, above the optic chiasma. It is noteworthy that most SCN efferent projections remain within the limits of the hypothalamus, and the best studied projection of SCN outside the hypothalamus is a multisynaptic projection to the pineal gland (see later). 4 SCN neurons isolated and kept in culture for several days still continue to show approximately 24-hour rhythms in action potential frequency. Metabolically, the SCNs show peak activity during the subjective day. This increased level of metabolism is paralleled by the increased electrophysiological activity evident from brain slice recordings. 5 The mean circadian period generated by the human SCN is approximately 18-24 hours. To remain perfectly entrained to the 24-hour cyclicity of the environment, ChronoPhysiology and Therapy downloaded from https: //www.dovepress.com/ by 44.224.250.200 on 11-Jul-2020 For personal use only.

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Is Circadian Rhythm Disruption Important in Obsessive-Compulsive Disorder (OCD)? A Case of Successful Augmentation With Agomelatine for the Treatment of OCD

Cited by 26 publications

References 11 publications

Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

Etiopathology and neurobiology of obsessive-compulsive disorder: focus on biological rhythms and chronotherapy

The melatonergic system: effects on sleep and implications for the treatment of psychiatric disorders

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