Agomelatine can treat depression and improve sleep. What should you pay attention to when using it?

Huazi had not been sleeping well recently, so he joked with his colleagues that he was in a bad mood recently and might have depression, which caused insomnia. But his colleagues told Huazi seriously that he could try agomelatine.

Huazi was joking when he said he had depression, but a friend who was suffering from depression once asked Huazi what to do if he was depressed and had insomnia. A colleague mentioned agomelatine, which can solve this problem. It is a new type of antidepressant that can improve sleep while treating depression.

1. Why can’t I feel happy anymore?

Depression is a common mental illness. In severe cases, it can lead to self-harm and suicide. The prevalence of depression is about 11% in the population, but only 3% of people can get treatment. When depression strikes, people cannot feel happy. Delicious food, beautiful scenery, and even the stimulation of money and beauty cannot arouse the interest of depressed people.

Many people believe that depression is a mental illness, but in fact, depression also involves physiological changes, which are mainly the result of hormone disorders in the brain.

There are two hormones in the human brain, norepinephrine (NE) and dopamine (DA), which can make people feel excited and happy; there is also a hormone, serotonin (5-HT). The role of 5-HT is very complex, and it can bind to a variety of receptors to play different roles. When it binds to the 5-HT2C receptor of the interneuron, it will play a negative regulatory role on NE and DA, helping us control our emotions and avoid overloading of brain nerves due to excessive excitement.

However, when the interneurons are abnormally active and the 5HT2C receptors bind to a large amount of 5-HT, it will block the information transmitted by "happy hormones" such as NE and DA, and our brain will not be able to feel "happiness".

2. The effect of agomelatine

Agomelatine can bind to the 5-HT2C receptor of the interneuron, thereby inhibiting the binding of the receptor to 5-HT. It can relieve the negative regulatory effects on NE and DA, so that the information of "happy hormone" can be transmitted normally, and we can feel the lost happiness again.

The structure of agomelatine is similar to that of human melatonin, and it can directly activate melatonin receptors (MT1 receptors, MT2 receptors). Melatonin is a hormone produced and released by the human body at night. It is responsible for maintaining the human circadian rhythm, improving the sleep cycle, and maintaining the duration and quality of sleep. Agomelatine can play the same role as melatonin, thereby improving sleep.

3. What should you pay attention to when taking medicine?

Traditional treatment for depression usually consists of a combination of antidepressants and sedatives, which suppress the central nervous system for a long time and cause drowsiness during the day. Agomelatine regulates sleep through the melatonin system, has little effect on the mental state during the day, and is less likely to cause drug dependence.

However, agomelatine is only effective for mild and moderate insomnia, and has a poor effect on severe or long-term insomnia. For those with severe insomnia, it is likely that they not only lack melatonin, but also have other diseases and mental factors, so agomelatine may not be effective.

Agomelatine has a significant effect on liver function, so liver function needs to be checked in the 3rd, 6th, 12th and 24th weeks of medication. If transaminase (AST, ALT) exceeds the upper limit of normal values, the medication needs to be discontinued. During medication, you should also pay close attention to whether there are symptoms of liver damage such as unexplained fatigue, darker urine, yellow skin or eyes, etc. If they occur, seek medical attention immediately.

Agomelatine may cause adverse reactions such as anxiety, headache, dizziness, nausea, back pain, and gastrointestinal reactions, but the symptoms are usually mild.

Agomelatine is mainly metabolized by the hepatic enzyme CYP1A2. Avoid using it in combination with strong CYP1A2 inhibitors (fluvoxamine, ciprofloxacin). Do not drink alcohol during medication.

To sum up, agomelatine has both antidepressant and sleep-improving effects, with fewer adverse reactions, but also weaker efficacy. Another obvious disadvantage is that it is expensive. People with depression should use medication under the guidance of a doctor, maintain a balanced diet, exercise regularly, establish good interpersonal relationships, and build a strong psychological defense for themselves to stay away from depression. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.