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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
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.
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- Copyright © European Psychiatric Association 2008
References
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