@article{3020687,
    title = "The preclinical discovery and development of agomelatine for the treatment of depression",
    author = "Konstantakopoulos, G. and Dimitrakopoulos, S. and Michalopoulou, P.G.",
    journal = "Expert Opinion on Drug Discovery",
    year = "2020",
    volume = "15",
    number = "10",
    pages = "1121-1132",
    publisher = "Taylor and Francis Ltd.",
    issn = "1746-0441, 1746-045X",
    doi = "10.1080/17460441.2020.1781087",
    keywords = "agomelatine;  acetamide derivative;  agomelatine;  antidepressant agent;  anxiolytic agent, antidepressant activity;  anxiety disorder;  Article;  circadian rhythm;  cost effectiveness analysis;  drug cost;  drug efficacy;  drug marketing;  drug safety;  drug tolerability;  human;  major depression;  mental disease;  pharmacodynamics;  postmarketing surveillance;  priority journal;  risk benefit analysis;  animal;  drug development;  major depression;  pathophysiology;  physiology, Acetamides;  Animals;  Anti-Anxiety Agents;  Antidepressive Agents;  Anxiety Disorders;  Circadian Rhythm;  Depressive Disorder, Major;  Drug Development;  Drug Discovery;  Humans",
    abstract = "Introduction: Under the treatment of commonly used antidepressants, many patients with major depressive disorder (MDD) do not achieve remission. All previous first-line treatments for depression have focused on the enhancement of monoaminergic activity. Agomelatine was the first antidepressant with a mechanism of action extending beyond monoaminergic neurotransmission. Areas covered: The aim of this case history is to describe the discovery strategy and development of agomelatine. The pharmacodynamic profile of the drug is briefly presented. The article summarizes (a) the preclinical behavioral data on agomelatine’s effects on depressive-like behavior, anxiety, and circadian rhythmicity disruptions, and (b) the results of early preclinical studies on safety, efficacy in MDD, and the risk-benefit pharmacological profile. Furthermore, the article examines findings of post-marketing research on safety, efficacy, and cost-effectiveness of the drug. Expert opinion: There is now evidence supporting the clinical efficacy and safety profile of agomelatine in the acute-phase treatment of MDD. Agomelatine may be more effective in specific subgroups of MDD patients, those with severe anxiety symptoms or disturbed circadian profiles. Its antidepressant and anxiolytic activities are due to synergy between its melatonergic and 5-hydroxytryptaminergic effects. Since its discovery, novel compounds acting on the melatonergic system have been under investigation for the treatment of MDD. © 2020 Informa UK Limited, trading as Taylor & Francis Group."
}