MedPath

Agomelatine

Generic Name
Agomelatine
Brand Names
Valdoxan
Drug Type
Small Molecule
Chemical Formula
C15H17NO2
CAS Number
138112-76-2
Unique Ingredient Identifier
137R1N49AD
Background

Agomelatine is structurally closely related to melatonin. Agomelatine is a potent agonist at melatonin receptors and an antagonist at serotonin-2C (5-HT2C) receptors, tested in an animal model of depression. Agomelatine was developed in Europe by Servier Laboratories Ltd. and submitted to the European Medicines Agency (EMA) in 2005. The Committee for Medical Products for Human Use (CHMP) recommended refusal of marketing authorization on 27 July 2006. The major concern was that efficacy had not been sufficiently shown. In 2006 Servier sold the rights to develop Agomelatine in the US to Novartis.

The development for the US market was discontinued in October 2011. It is currently sold in Australia under the Valdoxan trade name.

Indication

Agomelatine is indicated to treat major depressive episodes in adults.

Associated Conditions
Major Depressive Episode

Alto's ALTO-300 Shows Promise in Phase 2b Trial for Treatment-Resistant Depression

• Alto Neuroscience's ALTO-300, a novel biomarker-based antidepressant, advances in Phase 2b trial for Major Depressive Disorder with topline results expected by mid-2026. • The company's robust pipeline includes ALTO-203 for anhedonia, ALTO-101 for cognitive impairment in schizophrenia, and ALTO-100 for bipolar depression, with multiple data readouts expected in 2025-2026. • Previous open-label Phase 2a data demonstrated ALTO-300's superior efficacy in biomarker-positive patients, showing a 17-point MADRS improvement compared to 12.3 points in biomarker-negative patients.

Alto Neuroscience's ALTO-300 Shows Promise in Phase 2b Trial for Major Depressive Disorder

• Alto Neuroscience reports positive interim results from its Phase 2b trial of ALTO-300 as an adjunctive treatment for major depressive disorder (MDD). • The trial uses an EEG biomarker to identify patients likely to respond, with plans to enroll 200 biomarker-positive subjects for final analysis. • ALTO-300, an oral 5-HT2C antagonist and melatonin agonist, is being tested alongside existing antidepressants in patients with inadequate response. • The study's primary endpoint is the change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline, with topline data expected mid-2026.

Cybin's CYB003 Shows Sustained Efficacy in Phase 2 Depression Study

• Cybin's CYB003 demonstrated a 100% response rate and 71% remission rate in MDD patients after two 16mg doses, three weeks apart. • The Phase 2 study showed sustained treatment benefits through 12 months, validating the dosing regimen and durable effects of CYB003. • CYB003 has received Breakthrough Therapy Designation from the FDA, potentially expediting its review pathway for MDD treatment. • Cybin is advancing CYB003 into Phase 3 trials, expected to begin by the end of 2024, to further evaluate its efficacy in a larger MDD population.

Alto Neuroscience's ALTO-100 Fails to Meet Primary Endpoint in Phase 2b Depression Trial

• Alto Neuroscience's ALTO-100, designed to upregulate BDNF, did not meet the primary endpoint in a Phase 2b trial for major depressive disorder. • The trial, involving 301 participants, assessed the change in Montgomery-Åsberg Depression Rating Scale (MADRS) compared to placebo, but ALTO-100 showed no significant improvement. • Despite the disappointing results, Alto Neuroscience will analyze the data and continue developing other depression treatments like ALTO-203, ALTO-300 and ALTO-202. • ALTO-100 is still being tested for bipolar depression and PTSD, offering potential for success in different patient populations.

Alto Neuroscience's ALTO-100 Fails Phase 2b Trial for Major Depressive Disorder

• Alto Neuroscience's ALTO-100 failed to meet its primary endpoint in a Phase 2b trial for major depressive disorder (MDD), as measured by the MADRS scale. • The trial enrolled 301 adults with MDD, defined by a memory-based cognitive biomarker, across 34 sites in the U.S. • Despite the setback, Alto Neuroscience plans to analyze the full data set to determine future steps for ALTO-100 in MDD and remains committed to precision medicine in psychiatry. • The company's stock price plummeted following the announcement, but Alto expects its cash position to fund operations into 2027, with other clinical readouts anticipated.
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