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Jet lag, circadian rhythm sleep disturbances and depression : the role of melatonin and its analogs

机译:时差,昼夜节律性睡眠障碍和抑郁症:褪黑激素及其类似物的作用

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摘要

Travelling through several time zones results in a constellation of symptoms known as jet lag. These include reduced alertness, daytime fatigue, loss of appetite, reduced cognitive skills, and disruptions to sleep/wakefulness and other circadian rhythms. In susceptible air travel passengers, jet lag may exacerbate affective illness ans result in psychiatric morbidity. It is suggested that dysregulation of circadian rhythms and melatonin secretion represents the common underlying factor in jet lag and other circadian disorders. Hence the effective management of jet lag requires timely application of the well known chronobiotic melatonin. Recent studies have emphasized the importance of strategically timed administrations of melatonin and appropriate limited exposure to environmental schedules. However, with the introduction of the melatonergic agonists such as ramelteon and tasimelteon, which have both a strong affinity for MT1 and MT2 melatonin receptors and a longer half life, a new therapeutic option now exists for treating the sleep disturbances associated with jet lag. The melatonin analogs are unique inasmuch as they can also enhance daytime alertness. Since jet lag exacerbates affective disorders in susceptible air‐travel passengers, and can thus produce psychiatric morbidity, there is a need for an effective antidepressant with chronobiotic properties. In this regard the recently introduced melatonergic antidepressant agomelatine, which has successfully established its supremacy over other antidepressants in having chronobiotic effects, represents a good choice for treating depressive symptoms that are associated with jet lag.
机译:穿越几个时区会产生一系列症状,这些症状被称为时差。这些包括降低警觉性,白天疲劳,食欲不振,认知能力下降以及睡眠/清醒和其他昼夜节律的中断。在易受影响的空中旅行旅客中,时差可能会加剧情感疾病,并导致精神病发病。有人提出昼夜节律失调和褪黑激素分泌代表了时差和其他昼夜节律紊乱的常见潜在因素。因此,时差的有效管理要求及时应用众所周知的生时褪黑激素。最近的研究强调了对褪黑激素进行战略定时给药的重要性,以及适当限制接触环境的时间。但是,随着引入褪黑激素激动剂,例如雷美替尼和他西美替汀,它们对MT1和MT2褪黑激素受体具有很强的亲和力,并且半衰期更长,因此,现在存在一种新的治疗选择,用于治疗与时差相关的睡眠障碍。褪黑激素类似物之所以独特,是因为它们还可以增强白天的警觉性。由于时差会加重易乘飞机旅客的情感障碍,从而导致精神病发病,因此需要一种具有时变特性的有效抗抑郁药。在这方面,最近引入的褪黑素抗抑郁药阿戈美拉汀已成功确立其对其他抗抑郁药的优越性,具有时生性作用,是治疗与时差相关的抑郁症状的好选择。

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