Electroretinographic modifications induced by agomelatine: A novel avenue to the understanding of the claimed antidepressant effect of the drug?

Michele Fornaro, Fabio Bandini, Luca Cestari, Christian Cordano, Carla Ogliastro, Claudio Albano, Domenico De Berardis, Matteo Martino, Andrea Escelsior, Giulio Rocchi, Pantaleo Fornaro, Concetta De Pasquale

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Background: Agomelatine, the first melatonergic antidepressant, has been postulated to enhance the dopaminergic activity at the central nervous system by 5-hydroxytryptamine receptor type 2C (5-HT2C) antagonism, yet the impact of melatonergic agonism on this pathway is unclear. Previous studies employing simplified, yet reliable, proxy (retinal) measures of the central nervous system dopaminergic activity, namely the standard electroretinogram (ERG) technique, suggested a reduction of the dopaminergic activity of the main ERG parameter, the b-wave, by pure melatonin, notably a hormone devoid of any antidepressant activity. Therefore, the antidepressant effects of the melatonergic antidepressant drug agomelatine should be reflected by a differential b-wave trend at ERG versus the effect exerted by pure melatonin, which was eventually found to be due to a contrasting effect on central dopaminergic transmission between the two drugs. Objective and methods: The aim of the present preliminary ERG study carried out on healthy volunteers (n=23) receiving agomelatine was to explore the impact of this antidepressant drug on b-wave amplitude and latency of cones in daylight conditions using standard ERG. Results: As postulated, agomelatine induced an enhancement of retinal dopaminergic activity, in contrast to what has been previously documented for melatonin. Conclusion: Given the limits of this explorative study, especially the lack of a control group and that of a luminance response function to measure retinal sensitivity, further studies in clinical samples are recommended to allow more tenable conclusions about the potential role of ERG in discriminating between 5-HT antagonism and melatonergic (MT) agonism in relationship to the claimed antidepressant effect of agomelatine.

Original languageEnglish
Pages (from-to)907-914
Number of pages8
JournalNeuropsychiatric Disease and Treatment
Publication statusPublished - May 20 2014
Externally publishedYes


  • Dopamine, 5-HT2C
  • Electroretinogram
  • ERG

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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