Impact of the novel antidepressant agomelatine on disturbed sleep-wake cycles in depressed patients

Hum Psychopharmacol. 2010 Apr;25(3):222-9. doi: 10.1002/hup.1112.


Background: Disturbance of sleep-wake cycles is common in major depressive disorder (MDD), usually as insomnia, but also as hypersomnia or reduced daytime alertness. Agomelatine, an MT(1) and MT(2) receptor agonist and 5-HT(2C) receptor antagonist, represents a novel approach in MDD, with proven antidepressant efficacy and a positive impact on the sleep-wake cycle. We review the effects of agomelatine 25/50 mg/day on objective and subjective measures of the sleep-wake cycle in MDD.

Subjective measures: Agomelatine improved all aspects of the sleep-wake cycle from as early as 1 week in randomized trials versus selective serotonin reuptake inhibitors and venlafaxine, particularly getting off to sleep and quality of sleep, with an improvement in daytime alertness.

Objective measures: Agomelatine's effect on sleep architecture in MDD has been measured by polysomnography (PSG). There were significant improvements in sleep efficiency, slow-wave sleep (SWS), and the distribution of delta activity throughout the night, but no change in amount or latency of rapid eye movement (REM) sleep. Furthermore, the slow-wave sleep was resynchronized to the first sleep cycle of the night.

Conclusion: Agomelatine, a novel antidepressant, improves disturbed sleep-wake cycles in MDD. The improvement of both nighttime sleep and daytime functioning with agomelatine are promising features of this antidepressant regarding the management of MDD.

Publication types

  • Review

MeSH terms

  • Acetamides / pharmacology
  • Acetamides / therapeutic use*
  • Animals
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use*
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / psychology
  • Humans
  • Melatonin / agonists
  • Randomized Controlled Trials as Topic / methods
  • Sleep Disorders, Circadian Rhythm / complications
  • Sleep Disorders, Circadian Rhythm / drug therapy*
  • Sleep Disorders, Circadian Rhythm / psychology
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / psychology


  • Acetamides
  • Antidepressive Agents
  • agomelatine
  • Melatonin