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Agomelatina: un fármaco nuevo con acción antidepresiva que afecta a los sistemas melatonérgico y serotonérgico

Published online by Cambridge University Press:  12 May 2020

Luis San  and
Belen Arranz
Luis San
Affiliation:
Departamento de Psiquiatría, Hospital San Rafael, Barcelona, España.
Belen Arranz
Affiliation:
Servicios de Salud Mental, San Juan de Dios, Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, España.
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Resumen

La observavión clínica de que los trastornos depresivos a menudo se asocian con desincronización de los ritmos internos ha reforzado la idea de que recuperar los ritmos circadianos normales puede tener algún potencial antidepresivo. Agomelatina, un naftaleno análogo de melatonina, es a la vez agonista de los receptores humanos melatonérgicos MT1 y MT2 y antagonista de los receptores de serotonina 5-HT2C. Agomelatina combina la actividad sincronizadora (zeitgeber en alemán, sincronizador del sistema circadiano) con su capacidad de aumentar la neurotransmisión (aumenta las concentraciones de dopamina y noradrenalina en la corteza frontal). Se ha demostrado la eficacia de agomelatina en el tratamiento de la depresión en tres estudios a corto plazo, aleatorios y controlados por placebo. Estos estudios demostraron que agomelatina es eficaz en el trastorno depresivo mayor en una dosis estándar de 25 mg/día, con la posibilidad de aumentar la dosis a 50 mg/día en pacientes con mejoría insuficiente. El número de efectos adversos durante el período de tratamiento fue similar al del placebo. Cuatro estudios han demostrado el efecto positivo de agomelatina sobre la continuidad y la calidad del sueño y el acortamiento de la latencia del sueño. A pesar de que estos datos son prometedores, son necesarios otros estudios para examinar la eficacia de agomelatina durante un período de tratamiento más largo.

Keywords

Ritmos circadianosDepresiónTrastornos del sueñoMelatoninaAgomelatina
Type
Revisión
Information
European Psychiatry (Ed. Española) , Volume 15 , Issue 8 , November 2008 , pp. 375 - 381
Copyright
Copyright © European Psychiatric Association 2008

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