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Agomelatine but not melatonin improves fatigue perception: a longitudinal proof-of-concept study

Discussion in 'Latest ME/CFS Research' started by MikeJackmin, Mar 1, 2014.

  1. MikeJackmin

    MikeJackmin

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    http://www.sciencedirect.com/science/article/pii/S0924977X14000686

    Agomelatine but not melatonin improves fatigue perception: a longitudinal proof-of-concept study

    Abstract

    Chronic Fatigue Syndrome (CFS) represents a disabling condition characterized by persistent mental and physical fatigue, bodily discomfort and cognitive difficulties. To date the neural bases of CFS are poorly understood, however mono-aminergic abnormalities, sleep-wake cycle changes and prefrontal dysfunctions are all thought to play a role in the development and maintenance of this condition. Here we explored in a group of 62 CFS subjects the impact on fatigue levels of agomelatine, an antidepressant with agonist activity at melatonin receptors (MT1 and MT2) and antagonist activity at serotoninergic 2C receptors (5HT2C). To tease out the relative effects of MT-agonism and 5HT2C antagonism on fatigue, we compared agomelatine 50 mg u.i.d. with sustained release melatonin 10 mg u.i.d. in the first 12-week-long phase of the study, and then switched all melatonin-treated subjects to agomelatine in the second 12-week-long phase of the study. Agomelatine treatment, but not melatonin, was associated with a significant reduction of perceived fatigue and an increase in perceived quality of life. Moreover the switch from melatonin to agomelatine was associated with a reduction of fatigue levels. Agomelatine was well tolerated by all enrolled subjects. Our data, albeit preliminary, suggest that agomelatine treatment could represent a novel useful approach to the clinical care of subjects with CFS.
    NK17 likes this.
  2. adreno

    adreno 3% neanderthal

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    Tundras of Europa
    5-HT2C antagonism causes release of dopamine and norepinephrine in the brain.
  3. CFS_for_19_years

    CFS_for_19_years Senior Member

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    Seattle, WA
    Trade names are Valdoxan, Melitor and Thymanax.
    I'll ask about this at my next psych visit. Thanks for posting.

    ETA: Did not realize it's not available in US. Can be purchased online at Canadian pharmacies if you can afford it.
    Last edited: Mar 1, 2014
  4. NK17

    NK17 Senior Member

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    Thank you for bringing this up!

    Agomelatine is indeed a very interesting molecule and innovative drug with the big advantage of regulating circardian rythms and its ability to improve disrupted sleep patterns, without being sedating during the day.

    Sounds like the magic pill for many of us ;).

    I stumbled upon it while researching new types of drugs and even managed to get a small supply from Europe.

    This was back in 2011, back then there were preliminary rumors about the approval by the FDA for the US market.
    From a preliminary research it seems that it's still not available in the US.

    Of interest is the research done by Dr. Christian Guilleminault from Stanford University Sleep Disorders Clinic in California.

    I did not experiment with it, I still have the 2 boxes, which by now have experied ;(.

    All this makes me want to reach Dr. Guilleminault and put him in contact with Dr. Montoya at Stanford, one of the few doctors/researchers that is working tirelessly for PWME.
  5. lnester7

    lnester7 Seven

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    USA
  6. adreno

    adreno 3% neanderthal

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    Perhaps, but there are different forms of POTS, and some are helped by increased NE. I doubt it's a very strong effect, anyway.
  7. xchocoholic

    xchocoholic Senior Member

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    10 mg of melatonin is waaaay too much for me. My max during an episode of insomnia caused by gluten, caffeine and stress was 9 mg. I needed 5htp and theanine or klonopin too tho. And that left me feeling groggy for 2 days.

    I'm currently experimenting with .33-1 mg. So far I'm ok with taking it for 1-2 nights in a row but no longer than that.

    I don't know why they gave pwcs such a high dose of melatonin. We're known for needing less not more.

    Tc ... x

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