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Agomelatine for ADHD

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Agomelatine for ADHD

The trade name of agomelatine is Valdoxan.

Effect:

  • Agonistic to melatonin MT1 receptor
  • Agonistic to melatonin MT2 receptor
  • Blockade of the serotonin 5HT-2-B receptor in the nucleus suprachiasmaticus1
  • Blockade of the serotonin 5HT-2 C receptor in the nucleus suprachiasmaticus1

Agomelatine moderates a synchronization of circadian rhythms.23 It is therefore particularly worth considering in the case of a delayed sleep rhythm (which is common in ADHD sufferers).

70 to 80 % of all children with ADHD have sleep disorders.
For adults with ADHD, it is probably between 20 and 30%.

Sleep is eminently effective as a therapeutic agent in ADHD, as in all other disorders of the stress regulatory system. One hour more sleep at night reduces the cortisol level in the morning by 21%.

It is possible that agomelatine not only has a sleep-promoting and antidepressant effect, but also has an ADHD effect on its own: the efficacy of agomelatonin was compared with that of methylphenidate in a randomized double-blind study with n = 54 children. Both medications performed comparably in children’s parent and teacher ratings. Naturally, children treated with agomelatine had less sleep disturbance.4 Agomelatine, moreover, has been little studied as an ADHD medication.

  • Agomelatine causes 5HT2C receptor blockade, which indirectly causes an increase in norepinephrine and dopamine in the frontal cortex.1
  • However, agomelatine does not increase dopamine levels in the nucleus accumbens and striatum,1 where the dopamine deficit in ADHD causes the problems with drive and motivation and with attention regulated by motivation.
  • Norepinephrine levels in the frontal cortex are increased in a dose-dependent manner, with a concomitant increase in adrenergic activity in the nucleus coeruleus.1

In contrast, MPH and amphetamine drugs have a dopamine-increasing effect on PFC and striatum.

For agomelatine as a sleep medication, see also sleeping pills / sleep medication suitable for ADHD In the article Sleep problems in ADHD.