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5-
hydroxytryptamine
receptor 2C
Voltage-
dependent
P/Q-type
calcium channel
subunit
alpha-1A
Voltage-
dependent
L-type calcium
channel subunit
beta-1
Voltage-
dependent
calcium channel
subunit
alpha-2/delta-2
Synaptic
vesicular amine
transporter
Sodium-
dependent
serotonin
transporter
Tryptophan
5-hydroxylase 1
Aromatic-L-
amino-acid
decarboxylase
Ca
+
Serotonin
Serotonin
Agomelatine
Ca
+
Serotonin
Agomelatine
Agomelatine
L-Tryptophan
Tetrahydrobiopterin
O
2
5-Hydroxy-L-tryptophan
4a-Hydroxytetrahydrobiopterin
CO
2
Na
+
Na
+
Fe2+
Pyridoxal
5'-phosphate
Increase in
dopamine and
norepinephrine
release
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
↓ depressive symptoms
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Agomelatine binds to 5HT2C
receptors and increases
availability of dopamine and
norepinephrine
↑Cognitive Improvement
Brain
Raphei nuclei producing
serotonergic neurons
Blood vessel -blood brain
barrier
Passive Diffusion
Agomelatine also acts a
Melatonin MTI and MT2
receptor agonist
Agomelatine is taken orally
and absorbed from the
gastrointestinal tract.
Limbic system
HTR2C
CACNA1A
CACNB1
CACNA2D2
SLC18A2
SLC6A4
TPH1
DDC
Calcium
Serotonin
Serotonin
Agomelatine
Calcium
Serotonin
Agomelatine
Agomelatine
L-Tryptophan
Tetrahydrobiopterin
Oxygen
5-Hydroxy-L-
tryptophan
4a-
Hydroxytetrahydrobiopterin
Carbon dioxide
Sodium
Sodium
Increase in
dopamine and
norepinephrine
release
HTR2C
CACNA1A
CACNB1
CACNA2D2
SLC18A2
SLC6A4
TPH1
DDC
Ca
+
5-HT
5-HT
S20098
Ca
+
5-HT
S20098
S20098
Trp
BH4
O
2
5-HTP
4aHtHbp
CO
2
Na
+
Na
+
Fe2+
Pyr-5'P
I i d a
Synaptic Vesicle
Cytosol
Cytosol
Presynaptic Neuron
Postsynaptic Neuron
Synapse
↓ depressive symptoms
Serotonin is synthesized and
stored in synaptic vesicles
at the nerve terminal
Agomelatine binds to 5HT2C
receptors and increases
availability of dopamine and
norepinephrine
↑Cognitive Improvement
Brain
Raphei nuclei producing
serotonergic neurons
Blood vessel -blood brain
barrier
Passive Diffusion
Agomelatine also acts a
Melatonin MTI and MT2
receptor agonist
Agomelatine is taken orally
and absorbed from the
gastrointestinal tract.
Limbic system