Abstract:Melatonin is a hormone exerting its multiple actions mainly through two G-protein-coupled receptors MT(1) and MT(2). Exploring the physiological role of each of these subtypes requires subtype selective MT(1) and MT(2) ligands. While several MT(2)-selective ligands were developed in the 1990s, no selective agonists and antagonists for the MT(1) subtype were described. The present article reviews mela toninergic ligands developed in the current millennium focusing on subtype selective agents and on drug candida… Show more
“…Therefore, several melatonin agonists have been developed in recent years and examined in clinical trials for the treatment of insomnia (for a current review of melatonin receptor agonist development, see Turek and colleagues3). To date, agomelatine (S-20098; Valdoxan ® , Servier), a synthetic melatonergic MT 1 and MT 2 receptor agonist,4 is the best characterized melatonin receptor agonist in terms of preclinical studies. In contrast to melatonin, agomelatine also possesses serotonin (5-HT 2C ) receptor antagonistic properties5 within the central nervous system (CNS).…”
Introduction: Depressive disorders are among the main causes of disability due to disease. In spite of recent progress in the pharmacotherapy of depression, there is still a high nonresponse rate of ∼30% to the first antidepressant treatment. Furthermore, the latency of several weeks until sufficient clinical improvement and the risk of side effects remain unresolved problems. Therefore, there is still further need for the development of new antidepressants. In the last years a variety of melatonin receptor agonists have been synthesized and evaluated for the treatment of sleep disorders. Animal studies suggested that agomelatine (S-20098), a synthetic melatonergic MT 1 and MT 2 receptor agonist with serotonin receptor antagonistic properties, may have additional activating properties and may represent a new approach in the treatment of depression. Aims: Clinical trials that have demonstrated efficacy and safety of agomelatine for the treatment of depression are reviewed. Evidence review: In clinical trials, including phase III studies, superior efficacy compared to placebo and good efficacy compared to standard antidepressants was shown for agomelatine for the acute treatment of major depression. In all studies published so far agomelatine was safe and the overall tolerability profile was superior to selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors. Place in therapy: Agomelatine may represent a novel perspective in the treatment of acute depression. The improvement of sleep disturbances, the tolerability in terms of sexual side effects, and the lack of withdrawal symptoms after abrupt discontinuation of treatment may represent important clinical benefits compared to established antidepressants.
“…Therefore, several melatonin agonists have been developed in recent years and examined in clinical trials for the treatment of insomnia (for a current review of melatonin receptor agonist development, see Turek and colleagues3). To date, agomelatine (S-20098; Valdoxan ® , Servier), a synthetic melatonergic MT 1 and MT 2 receptor agonist,4 is the best characterized melatonin receptor agonist in terms of preclinical studies. In contrast to melatonin, agomelatine also possesses serotonin (5-HT 2C ) receptor antagonistic properties5 within the central nervous system (CNS).…”
Introduction: Depressive disorders are among the main causes of disability due to disease. In spite of recent progress in the pharmacotherapy of depression, there is still a high nonresponse rate of ∼30% to the first antidepressant treatment. Furthermore, the latency of several weeks until sufficient clinical improvement and the risk of side effects remain unresolved problems. Therefore, there is still further need for the development of new antidepressants. In the last years a variety of melatonin receptor agonists have been synthesized and evaluated for the treatment of sleep disorders. Animal studies suggested that agomelatine (S-20098), a synthetic melatonergic MT 1 and MT 2 receptor agonist with serotonin receptor antagonistic properties, may have additional activating properties and may represent a new approach in the treatment of depression. Aims: Clinical trials that have demonstrated efficacy and safety of agomelatine for the treatment of depression are reviewed. Evidence review: In clinical trials, including phase III studies, superior efficacy compared to placebo and good efficacy compared to standard antidepressants was shown for agomelatine for the acute treatment of major depression. In all studies published so far agomelatine was safe and the overall tolerability profile was superior to selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors. Place in therapy: Agomelatine may represent a novel perspective in the treatment of acute depression. The improvement of sleep disturbances, the tolerability in terms of sexual side effects, and the lack of withdrawal symptoms after abrupt discontinuation of treatment may represent important clinical benefits compared to established antidepressants.
“…10 Elucidation of the distinct functions of MT 1 and MT 2 receptors in many target tissues is still under investigation and requires a continual development of specific and selective affinity ligands. Whereas some selective MT 2 receptor ligands have been recently described, 11,12 the limited availability of MT 1 subtype-selective ligands has hampered an exhaustive elucidation of the MT 1 receptor patho/physiological role. Although, a few monomeric ligands displaying moderate MT 1 -selectivity were reported, 13 the most applied approach for the design of MT 1 selective receptor ligands relies in the preparation of symmetric dimers, by coupling two moieties deriving from known MLT receptor ligands.…”
“…[9] Parallel to the investigation of the pathophysiological role of MT 1 and MT 2 , various MLT receptor ligands have been developed. [10] The nonselective agonist ramelteon has been recently marketed as a new hypnotic drug, while other ligands are in clinical trials for the treatment of sleep disturbances or depression. [11] In the field of MLT receptor antagonists, different series of MT 2 -selective compounds have been described, [12] whereas examples of MT 1 -selective agents are still limited.…”
Racemic N-(8-methoxy-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-10-ylmethyl)acetamide (compound 5) was previously identified as a novel selective MT(2) antagonist fulfilling the requirements of pharmacophore and 3D QSAR models. In this study the enantiomers of 5 were separated by medium-pressure liquid chromatography and behaved as the racemate. Compound 5 was modified at the acylaminomethyl side chain and at position C8. The resulting analogues generally behaved as melatonin receptor antagonists (GTPgammaS test) with a modest degree of selectivity (up to 10-fold) for the MT(2) receptor. Changes at the amide side chain led to a decrease in binding affinity, whereas 8-acetyl and 8-methyl derivatives 12 and 11, respectively, were as potent as the 8-methoxy parent compound 5. Docking experiments with an MT(2) receptor model suggested binding modes consistent with the observed SARs and with the lack of selectivity of the enantiomers of 5.
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