Melatonin: A Suitable Agent for Depression Associated with Stroke?

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Back to table of contents Previous article Next article LETTERFull AccessMelatonin: A Suitable Agent for Depression Associated with Stroke?Ertugrul Cam Ph.D.,Burak Yulug M.D.,Nurettin Cengiz Ph.D.,Ester Poelkin Ph.D.,Dogan Isýk M.D.,Mustafa Bakar Ph.D.,Erol Ozan M.D.,Ertugrul Kilic Ph.D.,Ertugrul Cam Ph.D.Search for more papers by this author,Burak Yulug M.D.Search for more papers by this author,Nurettin Cengiz Ph.D.Search for more papers by this author,Ester Poelkin Ph.D.Search for more papers by this author,Dogan Isýk M.D.Search for more papers by this author,Mustafa Bakar Ph.D.Search for more papers by this author,Erol Ozan M.D.Search for more papers by this author,Ertugrul Kilic Ph.D.Search for more papers by this author,Published Online:1 Oct 2008AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: It is widely known that occurrence of poststroke mood disorders, especially depression, is one of the most frequent complications of stroke. 1 It affects approximately 20%–40% of all patients and the definitive treatment of this clinical picture includes various antidepressant agents. 1 The evidence about the antidepressant-like activity of melatonin and melatonin agonists is rapidly increasing. 2 – 7 However melatonin is also an important agent in sleep disturbances, which are shown to be associated with stroke. 8 In light of these findings we wanted to evaluate whether this novel antidepressant agent also has neuroprotective effect on cerebral ischemia. To examine this matter we evaluated the neuroprotective effect of melatonin in a relevant model for stroke in humans. Thus we administered the indole prophylactically for 4 weeks before the middle cerebral artery thread occlusions and evaluated the effects of melatonin treatment on ischemic brain injury 24 hours after reperfusion. Reproducibility of cerebral ischemia was controlled by Laser Doppler Flowmetry, and the neuroprotection was evaluated by infarct volume measurements ( Figure 1 ). Melatonin significantly reduced the infarct size ( Figure 1 ) (mean 1.12±0.5 mm 3 compared to 2.62±0.5 mm 3 ) when given prophylactically (p<0.05). This study was interesting with regard to poststroke depression by which a mood stabilizer with neuroprotective property would be preferable. Additionally, this finding supports that melatonin may be a suitable agent for patients with stroke and sleep disturbances, not only with its inhibiting effect on ischemic neuronal injury, but also with its improving effect on sleep disturbances. This can in turn provide additional support for the restorative process after brain injury. FIGURE 1. Infarct Volumes of Mice Subjected to Transient Cerebral IschemiaMelatonin led to a decrease in infarct size in treated animals. *Significantly different from vehicle-treated control animals (p≤0.05).However, further experiments to evaluate the long-term clinical applicability of such neuroprotective effects of melatonin in poststroke depression patients with MRI and spectroscopy studies would be the logical future steps to be taken in the field of psychiatric research.Department of Anatomy, University of Zurich, SwitzerlandDepartment of Psychiatry, University of Bern, SwitzerlandDepartment of Histology, University of 100.Yil, Van, TurkeyDepartment of Neurology, University of Göttingen, Göttingen, GermanyDepartment of Psychiatry, Dokuz Eylül University, İzmir, TurkeyDepartment of Neurology, Uludag UniversityDepartment of Psychiatry, Atatürk University, ErzurumDepartment of Physiology, University of Yeditepe, Istanbul, TurkeyReferences1 . 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