Parallel Changes in Mood and Melatonin Rhythm Following an Adjunctive Multimodal Chronobiological Intervention with Agomelatine in People with Depression: a Proof of Concept Open Label Study

Rebecca Robillard; Joanne Carpenter; Kristy-Lee Fields; Daniel F Hermens; Django White; Sharon L Naismith; Delwyn Bartlett; Bradley Whitwell; James Southan; Elizabeth M Scott; Ian B Hickie

doi:10.3389/fpsyt.2018.00624

Back

Parallel Changes in Mood and Melatonin Rhythm Following an Adjunctive Multimodal Chronobiological Intervention with Agomelatine in People with Depression: a Proof of Concept Open Label Study

Journal article

Open access

Peer reviewed

Parallel Changes in Mood and Melatonin Rhythm Following an Adjunctive Multimodal Chronobiological Intervention with Agomelatine in People with Depression: a Proof of Concept Open Label Study

Rebecca Robillard, Joanne Carpenter, Kristy-Lee Fields, Daniel F Hermens, Django White, Sharon L Naismith, Delwyn Bartlett, Bradley Whitwell, James Southan, Elizabeth M Scott, …

Frontiers in Psychiatry, Vol.9, 624

2018

DOI: https://doi.org/10.3389/fpsyt.2018.00624

Appears in Thompson Institute Research Collection

Files and links (2)

pdf

PDF - Published Version (Open Access)365.01 kBDownload View

Published VersionPDF - Published Version (Open Access)CC BY V4.0, Open Access

url

https://doi.org/10.3389/fpsyt.2018.00624View

Published Version

Abstract

Clinical Sciences

Public Health and Health Services

Psychology

melatonin agonist

agomelatine

melatonin

depression

circadian rhythms dysfunctions

Other Collaborations

Thompson Institute Special Collection

Background: Agomelatine is a melatonin agonist and 5HT antagonist developed for the treatment of major depressive disorder which also has some effects on the circadian system. Since circadian dysfunctions are thought to play a role in the pathophysiology of depression, some of the mechanism of action of this drug may relate to improvements in circadian rhythms. Objective: This proof of concept open-label study sought to determine if improvements in depressive symptoms following an adjunctive multimodal intervention including agomelatine intake are associated with the magnitude of circadian realignment. This was investigated in young people with depression, a subgroup known to have high rates of delayed circadian rhythms. Methods: Young people with depression received a psychoeducation session about sleep and circadian rhythms, were asked to progressively phase advance their wake up time, and completed an 8-week course of agomelatine (25-50 mg). Participants underwent semi-structured psychological assessments, ambulatory sleep-wake monitoring and measurement of melatonin circadian phase before and after the intervention. Results: Twenty-four young adults with depression (17-28 years old; 58% females) completed the study. After the intervention, depressive symptoms were significantly reduced (t(23) = 6.9, p < .001) and, on average, the timing of dim light melatonin onset (DLMO) shifted 3.6 hours earlier (t(18) = 4.4, p < .001). On average, sleep onset was phase shifted 28 minutes earlier (t(19) = 2.1, p = .047) and total sleep time increased by 24 minutes (t(19) = -2.6, p = 0.018). There was no significant change in wake-up times. A strong correlation (r = .69, p = .001) was found between the relative improvements in depression severity and the degree of phase shift in DLMO. Conclusion: Although this needs to be replicated in larger randomised controlled trials, these findings suggest that the degree of antidepressant response to a multimodal intervention including psychoeducation and agomelatine intake may be associated with the degree of change in evening melatonin release in young people with depression. This offers promising avenues for targeted treatment based on the prior identification of objective individual characteristics.

Details

Title: Parallel Changes in Mood and Melatonin Rhythm Following an Adjunctive Multimodal Chronobiological Intervention with Agomelatine in People with Depression: a Proof of Concept Open Label Study
Authors: Rebecca Robillard (Author) - University of Ottawa, Canada
Joanne Carpenter (Author) - University of Sydney
Kristy-Lee Fields (Author) - University of Sydney
Daniel F Hermens (Author) - University of the Sunshine Coast - Faculty of Arts, Business and Law
Django White (Author) - University of Sydney
Sharon L Naismith (Author) - University of Sydney
Delwyn Bartlett (Author) - Woolcock Institute of Medical Research
Bradley Whitwell (Author) - University of Sydney
James Southan (Author) - University of Sydney
Elizabeth M Scott (Author) - University of Sydney
Ian B Hickie (Author) - University of Sydney
Publication details: Frontiers in Psychiatry, Vol.9, 624; 8
Publisher: Frontiers Research Foundation
Date published: 2018
DOI: 10.3389/fpsyt.2018.00624
ISSN: 1664-0640
Copyright note: Copyright © 2018 Robillard, Carpenter, Feilds, Hermens, White, Naismith, Bartlett, Whitwell, Southan, Scott and Hickie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99451008802621
Output Type: Journal article

Metrics

20 File views/ downloads

367 Record Views

39 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Psychiatry

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites