Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data

Eppel, Alan B.

doi:10.1111/j.1399-5618.2008.00586.x

Cited by 10 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We agree with the caution that Dr. Eppel has recommended regarding the interpretation of these open agomelatine data (1). In addition, it is worth noting that compounds that do not cause sedation, increased appetite, and weight gain, such as is the case with agomelatine, tend to have difficulty separating from placebo.…”

supporting

confidence: 68%

Reply to Dr. Eppel regarding ‘Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data’

Muzina

Calabrese

2008

Bipolar Disorders

View full text Add to dashboard Cite

supporting

confidence: 68%

Reply to Dr. Eppel regarding ‘Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data’

Muzina

Calabrese

2008

Bipolar Disorders

View full text Add to dashboard Cite

“…On the other hand, since the ultimate goal of treatment in “acute” bipolar depression should be establishing long-term mood stability,32 the lack of additional follow up, ideally beyond 52 weeks,11 needs to be noted, although very few pilot studies would indeed follow this criterion. However, it is worthy of notice that during both the acute and extension periods of the trial, adjunctive agomelatine treatment was associated with improvement in depression, with favorable safety and tolerability profiles, including sensitive issues such as liver (there was no clinically relevant enzyme modification within the trial) and sexual function,29,33,34 although these latter outcomes were not assessed by ad hoc instruments, and improvement of subjective sleep quality – when initially impaired – was not assessed by actigraphic techniques or by other objective neurophysiological measurements due to the very preliminary nature of the study, whereas lithium or valproate may have contributed both to the antidepressant response and, possibly, to modulation of MT1/MT2 melatonergic receptors as already documented in animal models 35,36.…”

Section: Discussionmentioning

confidence: 99%

“…In pilot studies of type I BD (BD-I), agomelatine showed interesting results 10,11. Yet, to the best of our knowledge, no equivalent information has been provided about depression in type II BD (BD-II).…”

Section: Introductionmentioning

confidence: 99%

Adjunctive agomelatine therapy in the treatment of acute bipolar II depression: a preliminary open label study

Fornaro¹,

McCarthy²,

Berardis³

et al. 2013

NDT

View full text Add to dashboard Cite

PurposeThe circadian rhythm hypothesis of bipolar disorder (BD) suggests a role for melatonin in regulating mood, thus extending the interest toward the melatonergic antidepressant agomelatine as well as type I (acute) or II cases of bipolar depression.Patients and methodsTwenty-eight depressed BD-II patients received open label agomelatine (25 mg/bedtime) for 6 consecutive weeks as an adjunct to treatment with lithium or valproate, followed by an optional treatment extension of 30 weeks. Measures included the Hamilton depression scale, Pittsburgh Sleep Quality Index, the Clinical Global Impression Scale–Bipolar Version, Young Mania Rating Scale, and body mass index.ResultsIntent to treat analysis results demonstrated that 18 of the 28 subjects (64%) showed medication response after 6 weeks (primary study endpoint), while 24 of the 28 subjects (86%) responded by 36 weeks. When examining primary mood stabilizer treatment, 12 of the 17 (70.6%) valproate and six of the 11 (54.5%) lithium patients responded by the first endpoint. At 36 weeks, 14 valproate treated (82.4%) and 10 lithium treated (90.9%) subjects responded. At 36 weeks, there was a slight yet statistically significant (P = 0.001) reduction in body mass index and Pittsburgh Sleep Quality Index scores compared to respective baseline values, regardless of mood stabilizer/outcome. Treatment related drop-out cases included four patients (14.28%) at week 6 two valproate-treated subjects with pseudo-vertigo and drug-induced hypomania, respectively, and two lithium-treated subjects with insomnia and mania, respectively. Week 36 drop outs were two hypomanic cases, one per group.ConclusionAgomelatine 25 mg/day was an effective and well-tolerated adjunct to valproate/lithium for acute depression in BD-II, suggesting the need for confirmation by future double blind, controlled clinical trials.

show abstract

“…Agomelatin was found to synchronize circadian rhythms involving body temperature, cortisol and other hormones in animal models and in humans, which may underlie some of its therapeutic effects (174). Three studies have reported the efficacy of agomelatin as an adjunctive treatment in bipolar depression (175)(176)(177).…”

Section: Focused Circadian Pharmacological Treatmentsmentioning

confidence: 99%

Circadian abnormalities as markers of susceptibility in bipolar disorders

et al. 2014

View full text Add to dashboard Cite

Chronobiological models have contributed to a better understanding of the pathophysiology of bipolar disorders. Circadian functions dysregulations are associated with bipolar disorders, including biochemical (melatonin and cortisol profiles), actigraphic (sleep/wake patterns), and dimensional (chronotypes) circadian markers. These associations are observed not only during acute episodes but also during euthymic periods. Most markers that are associated with bipolar disorders are also found in the healthy relatives of patients, suggesting a strong degree of heritability. As such, they may serve as trait markers of the disorder. Several circadian genes have been found to be associated with bipolar disorders: at least three studies have reported positive associations for each of CLOCK, NPAS2, ARNTL1, NR1D1, PER3, RORB and CSNK1epsilon. Thus the clock machinery may contribute to the genetic susceptibility to bipolar disorders. The circadian model theory has also led to the development of novel therapeutic strategies such as InterPersonal and Social Rhythms Therapy and chronotherapeutics. Additionally, the circadian model theory may help explain how mood stabilizers (in particular lithium carbonate) bring about their therapeutic effects.

show abstract

Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data

Cited by 10 publications

References 3 publications

Reply to Dr. Eppel regarding ‘Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data’

Reply to Dr. Eppel regarding ‘Letter to the Editor: Agomelatine adjunctive therapy for acute bipolar depression: preliminary open data’

Adjunctive agomelatine therapy in the treatment of acute bipolar II depression: a preliminary open label study

Circadian abnormalities as markers of susceptibility in bipolar disorders

Contact Info

Product

Resources

About