Depression and associated sleep disturbances: patient benefits with agomelatine

SummaryThe essential linkage of sleep disturbance and clinical depression has long been recognized. Almost all patients with major depression report some form of sleep difficulty including insomnia, oversleeping, and poor-quality sleep. Some have argued that these changes in the sleep-wake cycle are actually aspects of a more fundamental alteration in circadian rhythms. Antidepressants that reduce restless sleep and awakenings and improve daytime alertness are desirable. It also appears that compounds that “rearrange” the intensity of rapid eye movement and slow-wave sleep may provide the best clinical effects on sleep besides antidepressant clinical efficacy. Agomelatine, a new antidepressant with melatonergic activity and 5-HT2c antagonist properties, has shown its efficacy in major depression. Beyond this antidepressant efficacy, agomelatine demonstrates sleep electroencephalographic changes consistent with desirable sleep architecture improvements, as well as improved subjective sleep quality within the first week of administration accompanied by an improvement in daytime alertness.