Agomelatine

Agomelatine

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Melatonergic antidepressant
Sedating: Can be Driving: Caution QT risk: Low Akathisia: Low Metabolic: Low Prolactin: Low t½: 2.5 h Tmax: 1 h

A melatonin-based antidepressant that works differently to the usual SSRIs/SNRIs. It aims to reset circadian rhythms while nudging serotonin receptors. The pitch is: better sleep, fewer sexual side effects. The reality: mixed results, rare liver toxicity (needs blood monitoring), and patchy NHS availability. Still, for some, it’s a smoother, gentler antidepressant than the usual suspects.

🩺 Main Uses

Major depression (especially with sleep disturbance).

🧪 The Science & Facts

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Half‑life (t½)

2.5 h

How long the drug hangs around. Longer half‑life = slower changes.

Time to Peak (Tmax)

1 h

Roughly when you feel the main effect after a dose.

What it hits (receptors)

Primary:

MT1/MT2 (agonist)5-HT2C (antagonist)

Improves sleep architecture without typical sedative hangover.

How your body processes it (metabolism)

Improves sleep architecture without typical sedative hangover.

⚠️ Warnings

  • Hepatotoxicity risk — requires baseline and periodic LFTs; stop if liver enzymes rise.

⏬ Taper & Withdrawal

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If you’re reducing

No physiological dependence; can stop or taper over 1–2 weeks.

Possible withdrawal

Usually mild (sleep change, headache).

Info here is educational, not medical advice. Always taper with prescriber support if possible.

🧠 Trusted External Sources Last reviewed 22 Aug 2025, 21:12 by Connor O'Driscoll

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⚠️ Black Box Warning

Monitor liver function - risk of liver injury.

This is a plain‑English summary of headline safety warnings. Talk to a clinician before changing any medication.