An antidepressant
Agomelatine
An antidepressant for major depression that works on the body clock and may help sleep, but needs liver-function checks.
What is Agomelatine?
Agomelatine is an antidepressant used for major depression in adults. It acts on melatonin (body-clock) receptors and serotonin, and may help with disturbed sleep. It needs regular liver blood tests because it can occasionally affect the liver.
Education and reference only. This is a plain-language guide to Agomelatine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Agomelatine is an antidepressant used in adults with major depression. It is sometimes chosen because it can help with the disturbed sleep that often comes with depression and tends not to cause the sexual side effects or weight gain seen with some other antidepressants. It is taken as a once-daily tablet, usually at bedtime.
How it works
Agomelatine works differently from most antidepressants. It stimulates melatonin receptors, which help reset the body clock and can improve sleep patterns, while also acting on a particular serotonin receptor that is thought to contribute to its mood-lifting effect. Together these actions help restore normal sleep-wake rhythms and gradually improve mood.
Company & origin
Originated / developed by: Servier (originator).
A melatonin-based antidepressant introduced for major depression in the late 2000s.
What it treats
Conditions Agomelatine is used for
Practical use
How to take Agomelatine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is usually taken once a day at bedtime, which fits with its effect on sleep.
- It can be taken with or without food.
- Keep to the liver blood-test appointments arranged before and during treatment — these are important for safety.
- Report yellowing of the skin or eyes, dark urine, pale stools or unusual tiredness straight away, as these can signal a liver problem.
- If you miss a dose, skip it and take the next one as usual at bedtime — do not take two doses together.
Weighing it up
Advantages & disadvantages of Agomelatine
Advantages
- May improve disturbed sleep that often comes with depression.
- Tends not to cause sexual side effects or weight gain, unlike some other antidepressants.
- Discontinuation symptoms on stopping are generally less of a problem than with several other antidepressants.
Disadvantages
- Requires regular liver blood tests, which not everyone wants or can keep up with.
- Cannot be used by people with liver problems.
- Like all antidepressants, it takes weeks to work rather than days.
Practical use
Good to know
It is usually taken at bedtime and can help with the broken sleep that often accompanies depression. Because it can occasionally affect the liver, blood tests to check liver function are done before starting and at intervals afterwards, and it is not suitable for people with liver problems. As with all antidepressants, it should not be stopped suddenly and the benefit takes a few weeks to build. Report any signs of liver trouble, such as yellowing of the skin or eyes, dark urine or unusual tiredness.
Who should not take it / use with caution
- People with liver impairment or active liver disease, or with persistently raised liver blood tests.
- People taking certain medicines that strongly raise its levels (such as the antidepressant fluvoxamine or some antibiotics).
- Used with caution in older adults with dementia, and the risks and benefits should be discussed in pregnancy and breastfeeding.
Monitoring
- Liver function blood tests before starting and at intervals during treatment.
- Mood and any thoughts of self-harm, especially early on and in people under 25.
- Response to treatment and any side effects at review.
Side effects
- Headache, dizziness, drowsiness, nausea and diarrhoea or constipation can occur.
- Sleep disturbance, anxiety or unusual dreams are sometimes reported.
- Rarely, liver problems — yellowing of the skin or eyes, dark urine or unusual tiredness need prompt review; worsening mood or thoughts of self-harm should also be reported.
Key interactions
- It must not be combined with fluvoxamine, and care is needed with some antibiotics and other medicines that raise its levels and liver risk.
- Avoid drinking significant amounts of alcohol, which adds to the strain on the liver.
- Tell your pharmacist about all your medicines, as some can interfere with how agomelatine is broken down.
Available as: Tablets.
Answers
Agomelatine: frequently asked questions
Why do I need blood tests with agomelatine?
It can occasionally affect the liver, so liver-function blood tests are done before you start and at set points afterwards to make sure it is safe to continue.
Will agomelatine help me sleep?
It acts on the body clock and can help with the disturbed sleep that often comes with depression, which is why it is usually taken at bedtime.
Does it cause weight gain or sexual side effects?
It tends not to, which is one reason it is sometimes chosen over other antidepressants. Tell your prescriber if you notice any unwanted effects.
Is agomelatine the same as Valdoxan?
Yes. Agomelatine is the active-ingredient name and Valdoxan is a brand name for the same medicine.
Can I drink alcohol while taking it?
It is best to avoid drinking much alcohol, because both alcohol and agomelatine can affect the liver and the combination adds to that risk.
Authoritative sources
- BNF: Agomelatine.
- NICE CKS: Antidepressants.
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