Agomelatine Improves Apathy in Frontotemporal Dementia.

Area of Science:

• Neuroscience
• Pharmacology
• Psychiatry

Background:

• Apathy is a primary symptom of frontotemporal dementia (FTD), linked to dopaminergic system dysfunction.
• Currently, no approved pharmacological treatments exist for apathy in FTD.
• This study explored enhancing prefrontal dopaminergic innervation to alleviate apathy.

Purpose of the Study:

• To assess the efficacy of agomelatine in treating apathy in behavioral variant FTD (bvFTD).
• To investigate the role of 5-HT2C antagonism in improving apathy.
• To compare agomelatine with melatonin in patients with bvFTD.

Main Methods:

• A double-blind, randomized, cross-over study involving 24 non-depressed bvFTD patients.
• Patients received either agomelatine (50 mg/day) or melatonin (10 mg/day) for 10 weeks.
• A subsequent switch to agomelatine was performed after the initial treatment period.

Main Results:

• Agomelatine significantly reduced apathy symptoms in FTD patients.
• Agomelatine also decreased caregiver distress associated with patient apathy.
• Melatonin did not show a significant effect on apathy, but switching to agomelatine did.

Conclusions:

• Agomelatine shows promise as a novel therapeutic option for apathy in FTD.
• The findings suggest a potential benefit of targeting dopaminergic pathways for FTD-related apathy.
• Agomelatine was well-tolerated in the study population.