Agomelatine but not melatonin improves fatigue perception: A longitudinal proof-of-concept study |
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| Institution: | 1. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy;2. Center for Communication and Neurorehabilitation Research-CNAPP, Rome, Italy;3. Mental Health and Se.R.T. Department, National Health Service, Ancona, Italy;4. Psychiatric Inpatient Unit, Civil Hospital, Lavagna (GE), Italy;5. Department of Neurology, IRCCS S. Martino Hospital-IST, Genoa, Italy;6. Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy;1. Clinical Neurology, Faculty of Medicine, Mersin University, Turkey;2. Biostatistics, Faculty of Medicine, Mersin University, Turkey;1. Psychological Medicine Research, University of Oxford Department of Psychiatry, Oxford, UK;2. Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King''s College London, London, UK;3. Academic Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King''s College London, London, UK;4. Medical Research Council Clinical Trials Unit at UCL, London, UK;5. Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Bart''s and The London Medical School, Queen Mary University of London, London, UK;1. Department of Pharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Deraya University, Minia, Egypt;2. Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Minia, Egypt;3. Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia, Egypt;1. National Heart and Lung Institute, Imperial College London, London, UK;2. National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK;3. Patient Experience Research Centre, Imperial College London, London, UK;4. Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK;5. Clinical Health Psychology, Imperial College Healthcare NHS Trust, London, UK;6. Learning and Participation, English National Opera, London, UK;7. Department of Health Sciences, Brunel University London, London, UK;1. The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade, Aarhus, Denmark;2. Psychiatric Hospital Risskov, Aarhus University Hospital, Skovagervej, Risskov, Denmark;3. Danish Pain Research Center, Aarhus University Hospital, Noerrebrogade, Aarhus, Denmark |
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| 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. |
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| Keywords: | Fatigue Dopamine Noradrenaline Agomelatine Melatonin |
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