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Successful Treatment with Agomelatine in NES: A Series of Five Cases.

Milano W, De Rosa M, Milano L, Riccio A, Sanseverino B, Capasso A - Open Neurol J (2013)

Bottom Line: The NES is an emerging disease in eating behavior that combines eating disorders, sleep, mood and stress.The serum chemistry values ​​remained stable and there were no reported adverse events.The present study showed that the treatment with agomelatine has improved the symptoms of NES and mood, decrease of body weight, reduce, albeit not in an optimal manner, the number of awakenings per night with a reduction of movement time and snoring .

View Article: PubMed Central - PubMed

Affiliation: Mental Health Unit- Distrect 24 - ASL Napoli 1 Center Department of Pharmacy, University of Salerno, Italy.

ABSTRACT
The NES is an emerging disease in eating behavior that combines eating disorders, sleep, mood and stress. In recent years, the NES is becoming more interested in close association with obesity and depression. In the present study we have followed for 12 weeks 5 patients (2 males and 3 females) with NES and comorbid depression treated with agomelatine (25 mg / day for the first two weeks, then 50 mg / day), an antidepressant similar of melatonin. At the end of the three months of treatment, it was found an improvement in symptoms characteristic of the NES, as assessed by a reduction an average of the NEQ (from 31 to 22.8), improved mood, mean values ​​reduced by 23, 2 to 13.2 on the HAM-D, weight reduction, an average of 3.6 kg reduction in average weekly awakenings from 12 to 6.4 and the time of snoring and motion detected polysomnography. The serum chemistry values ​​remained stable and there were no reported adverse events. The present study showed that the treatment with agomelatine has improved the symptoms of NES and mood, decrease of body weight, reduce, albeit not in an optimal manner, the number of awakenings per night with a reduction of movement time and snoring . Of course, these preliminary data need to be confirmed by controlled trials on a larger sample.

No MeSH data available.


Related in: MedlinePlus

Mechanism of action of Agomelatine [21,27].Therefore, in the present paper we report the effect of agomelatine in five NES patient.
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Figure 1: Mechanism of action of Agomelatine [21,27].Therefore, in the present paper we report the effect of agomelatine in five NES patient.

Mentions: Agomelatine is a potent agonist of MT1 and MT2 receptors, they are present in various areas of the brain especially at the level of the suprachiasmatic nucleus, hippocampus, hypothalamus and cerebellum and it is also an antagonist of serotonergic 5-HT2c receptors, while the affinity for other receptors is negligible [20,21]. The affinity for the MT1 and MT2 receptors in vivo is 5 times higher than that for serotoninergic and being agomelatine a highly lipophilic substance able to cross the blood-brain barrier and reaches micromolar concentrations sufficient to exert its action on both types of receptors. Furthermore, despite the agomelatine is not a monoamine reuptake inhibitor, has been shown a dose-dependent increase of extracellular concentrations of dopamine and norepinephrine selectively at the level of the frontal cortex [20-22]. Recent evidence has shown that agomelatine increases the expression of the "brain-derived neurotrophic factor" (BDNF), a trophic factor and a marker of neuroplasticity, which is believed to have an important role in mood disorders, in the prefrontal cortex and hippocampus. In addition, it also increases the expression of '"activity-regulated cytoskeleton-associated protein" (ARC), which is involved in the sleep / wake cycle at the level of the prefrontal cortex [23-26]. Therefore chronic therapy with agomelatine has been shown to increase neurogenesis in hippocampal level, to lengthen the survival of neuronal cells and to attenuate the release of glutamate induced by stress at the cortical level [27]. These results indicate that agomelatine acts through a synergistic action on receptors and MT1/MT2 5HT2c, leading to a re-synchronization of circadian rhythms through an effect on the "clock genes", the release of glutamate, the expression of BDNF, ARC and on neurogenesis [28] (Fig. 1 and 2).


Successful Treatment with Agomelatine in NES: A Series of Five Cases.

Milano W, De Rosa M, Milano L, Riccio A, Sanseverino B, Capasso A - Open Neurol J (2013)

Mechanism of action of Agomelatine [21,27].Therefore, in the present paper we report the effect of agomelatine in five NES patient.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3795402&req=5

Figure 1: Mechanism of action of Agomelatine [21,27].Therefore, in the present paper we report the effect of agomelatine in five NES patient.
Mentions: Agomelatine is a potent agonist of MT1 and MT2 receptors, they are present in various areas of the brain especially at the level of the suprachiasmatic nucleus, hippocampus, hypothalamus and cerebellum and it is also an antagonist of serotonergic 5-HT2c receptors, while the affinity for other receptors is negligible [20,21]. The affinity for the MT1 and MT2 receptors in vivo is 5 times higher than that for serotoninergic and being agomelatine a highly lipophilic substance able to cross the blood-brain barrier and reaches micromolar concentrations sufficient to exert its action on both types of receptors. Furthermore, despite the agomelatine is not a monoamine reuptake inhibitor, has been shown a dose-dependent increase of extracellular concentrations of dopamine and norepinephrine selectively at the level of the frontal cortex [20-22]. Recent evidence has shown that agomelatine increases the expression of the "brain-derived neurotrophic factor" (BDNF), a trophic factor and a marker of neuroplasticity, which is believed to have an important role in mood disorders, in the prefrontal cortex and hippocampus. In addition, it also increases the expression of '"activity-regulated cytoskeleton-associated protein" (ARC), which is involved in the sleep / wake cycle at the level of the prefrontal cortex [23-26]. Therefore chronic therapy with agomelatine has been shown to increase neurogenesis in hippocampal level, to lengthen the survival of neuronal cells and to attenuate the release of glutamate induced by stress at the cortical level [27]. These results indicate that agomelatine acts through a synergistic action on receptors and MT1/MT2 5HT2c, leading to a re-synchronization of circadian rhythms through an effect on the "clock genes", the release of glutamate, the expression of BDNF, ARC and on neurogenesis [28] (Fig. 1 and 2).

Bottom Line: The NES is an emerging disease in eating behavior that combines eating disorders, sleep, mood and stress.The serum chemistry values ​​remained stable and there were no reported adverse events.The present study showed that the treatment with agomelatine has improved the symptoms of NES and mood, decrease of body weight, reduce, albeit not in an optimal manner, the number of awakenings per night with a reduction of movement time and snoring .

View Article: PubMed Central - PubMed

Affiliation: Mental Health Unit- Distrect 24 - ASL Napoli 1 Center Department of Pharmacy, University of Salerno, Italy.

ABSTRACT
The NES is an emerging disease in eating behavior that combines eating disorders, sleep, mood and stress. In recent years, the NES is becoming more interested in close association with obesity and depression. In the present study we have followed for 12 weeks 5 patients (2 males and 3 females) with NES and comorbid depression treated with agomelatine (25 mg / day for the first two weeks, then 50 mg / day), an antidepressant similar of melatonin. At the end of the three months of treatment, it was found an improvement in symptoms characteristic of the NES, as assessed by a reduction an average of the NEQ (from 31 to 22.8), improved mood, mean values ​​reduced by 23, 2 to 13.2 on the HAM-D, weight reduction, an average of 3.6 kg reduction in average weekly awakenings from 12 to 6.4 and the time of snoring and motion detected polysomnography. The serum chemistry values ​​remained stable and there were no reported adverse events. The present study showed that the treatment with agomelatine has improved the symptoms of NES and mood, decrease of body weight, reduce, albeit not in an optimal manner, the number of awakenings per night with a reduction of movement time and snoring . Of course, these preliminary data need to be confirmed by controlled trials on a larger sample.

No MeSH data available.


Related in: MedlinePlus