Profile of agomelatine and its potential in the treatment of generalized anxiety disorder

Michelle Nigri Levitan,1 Marcelo Papelbaum,1,2 Antonio Egidio Nardi1 1Laboratory of Panic and Respiration, Institute of Psychiatry of the Federal University of Rio de Janeiro, 2State Institute of Diabetes and Endocrinology of Rio de Janeiro, Rio de Janeiro, Brazil Background: Although many generalized anxiety disorder (GAD) patients respond to the available pharmacological treatments, nearly half of them do not present the expected results. Besides, the side effects associated to some drugs have a negative impact on treatment adherence. Therefore, the aim of this review was to report the clinical profile of agomelatine, a selective melatonergic MT1/MT2 receptor agonist with serotonin 5-HT2c receptor antagonist activities, as a potential pharmacological option in the treatment of GAD.Methods: We performed a literature review regarding studies that evaluated the use of agomelatine in GAD treatment. Results: Two short-term, double-blinded studies and one prevention-treatment trial evaluated the efficacy of agomelatine in the treatment of GAD. Agomelatine was associated with higher rates of clinical response and remission, when compared to placebo. In addition, the long-term use of agomelatine decreased the risk of relapse of anxiety symptoms, even for the severely ill patients. Besides, the tolerability was satisfactory with the absence of discontinuation symptoms, as observed in previous studies.Conclusion: The efficacy and tolerability profiles of agomelatine in the treatment of GAD were good. However, the scarce number of trials, the small sample sizes, and the use of patients without any comorbid conditions were some limitations that impaired the generalization of the results in the general population. Nevertheless, agomelatine is an attractive off-label option in the treatment of GAD that needs more conclusive evidences to establish its role in future guidelines. Keywords: agomelatine, generalized anxiety disorder, pharmacological treatmen

Binge eating disorder: A 5-year retrospective study on experimental drugs

Binge eating disorder (BED) affects a significant rate of the general population causing a negative impact on their quality of life, weight, and self-esteem. Besides psycho-logical treatments that compose the majority of the studies, pharmaceuticals have contributed to improve a host of clinical parameters, thus being an important component of the treatment. We opted to target the latest results by performing a review of the literature on the pharmacology for BED from the last 5 years. To achieve this goal, the terms: “binge eating disorder” and “treatment” were added to the PubMed database and the website clinicaltrials. gov. At least five drugs were either being tested or had already been recognized to improve BED symptoms – although only lisdexamfetamine is currently approved by the FDA to treat this condition. However, due to a better understanding of BED psychopathology in the last decade, it is notorious that improvement of eating-related symptoms is not the only desired target. Due to the significant comorbidity percentage (30%), weight loss is highly pursued, as well as the amelioration of clinical parameters which highlights the importance of having new agents combining both objectives