Agomelatine as a Novel Pharmacotherapy of Anxiety Disorders

Min, Jung Ah; Chae, Jeong Ho

Abstract

Anxiety disorders are the most common mental health problems and frequently cause functional impairment. Although current pharmacological agents are recognized to be effective, partial or total resistance to drug treatment and distressing side effects have leaded to continued search of a new pharmacotherapy of anxiety disorders. Agomelatine is a novel agent with a melatonergic agonist at MT1 and MT2 receptors and an antagonist at 5HT2C receptors. Despite substantial evidence of its antidepressant properties, the anxiolytic properties of agomelatine have been underscored. Therefore, this article reviews previous studies on anxiolytic properties of agomelatine. In several rat models, agomelatine actively reduces anxiety-related behaviors comparable to benzodiazepine. These anxiolytic properties seem to be mediated by both melatonergic and 5HT2C receptors. Randomized, double-blind, clinical trials demonstrated that agomelatine 25-50 mg/day significantly reduced anxiety symptoms in patients with generalized anxiety disorder as well as major depressive disorder. Recently, cases of panic disorder and social anxiety disorder successfully treated with agomelatine were reported. In addition, the tolerability of agomelatine seems broadly favorable, particularly in sexual dysfunction and discontinuation syndrome. Based on these sound efficacy and tolerability profiles, further studies on the use of agomelatine in anxiety disorders will be required for wider clinical application.