27 November 2017

Take 6: The melatonergic pathway

Clinical Psychiatry

Is there a way of using the melatonin system as an antidepressant?

A drug called agomelatine, released in Australia several years ago, does just this.

It works on the melatonin and serotonergic system synergistically, says Dr Tom Paterson, a psychiatrist and the director of the Adelaide Clinic Community Service.

“The question is why,” he says. “None of us are really sure but then if you ask people how any antidepressants work, none of us are really sure.”

One of the theories is that brain-derived neurotrophic factor (BDNF) is necessary for brain growth and neuroplasticity.

“The theory is that if you stimulate BDNF, you increase the growth of new synaptic connections and you make the brain functional,” says Dr Paterson.

“You don’t get an immediate response,” he says. “It’s a bit like fertilising your roses. They don’t bloom tomorrow, they bloom in several weeks.”