Time of melatoninomimetics

In meteopathy and desynchronosis, great importance is attached to disturbances in the production of melatonin. It is even believed that geomagnetic factors exert their biotropic action through the effect on the synthesis of melatonin. In violations of melatonin metabolism, the value belongs to a variety of external and internal factors.

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Apart from diseases of the pineal gland itself, one of its most common and therefore most important factors is age involution, when among other systems the synthesis and secretion of melatonin by this organ progressively decreases. Since with age, the diseases only accumulate, each of them, unless it starts against a background of disturbances in melatonin metabolism, is necessarily accompanied by these disorders with time. A direct relationship with melatonin deficiency of such conditions as insomnia, depression, neurosis, Alzheimer’s disease, Parkinson’s disease, tumor and immunodeficiency diseases has been proved. It is necessarily found in diseases of the cardiovascular system, primarily arterial hypertension and coronary heart disease, digestive, primarily peptic ulcer of the stomach and duodenum, and other systems.  It is the companion of many diseases of the genital sphere. Since the activity of the epiphysis decreases with age, the synthesis of melatonin falls, and sleep becomes superficial and restless. On this mechanism, adults develop insomnia. On the other hand, under the influence of a number of factors, the synthesis of melatonin may increase, and then drowsiness increases. Its extreme variant is a seasonal affective disorder, in extreme cases of which a person sleeps for days, waking up only for meals and physiological items. The inversion of the light regime is one of the most important factors in the disturbance of circadian oscillations in the synthesis and secretion of melatonin, which occur after it with a delay of several days. Circadian disorders are superimposed on the structure of any pathological process taking place in the patient, not only weighting the course, but also making the medical interventions less effective, not allowing to achieve the expected results. Diagnosis of metabolic disturbances of melatonin is based on the determination of its concentration in the blood plasma and the products of its metabolism in the urine. When determining melatonin in blood plasma, it should be borne in mind that its half-life is only 45 minutes. With urine, up to 80-90% melatonin is released in the form of melatonin sulfate and 6-hydroxyglycuronide. Their concentrations in the urine are closely correlated with the concentration of melatonin in the blood plasma, and in practice, their determination can be limited. Attributed to melatonin the central place in the regulation of human biological rhythms, the realized the extremely important role of the quality of the latter (and, therefore, of melatonin itself) in human health and disease became the motive for creating on its basis new generations of medications that have melatonin cerebral receptors attached. By normalizing the rhythm of the biological clock, these preparations harmonize most of the functions of the human body, thus contributing to the increase of its restorative and protective potential and, thus, have a positive effect on the course and outcomes of the majority of pathological processes. Such physiological effects of melatonin and melatoninomimetics as hypnotics, hypothermic, antioxidant, antitumor, adaptogenic, synchronizing, antistress, antidepressant, immunomodulating, anticonvulsant and others are primarily related to their positive influence on the structure of human biological rhythms. One example of melatoninomimetics is the melatoninergic antidepressant agomelatine? a melatonin MT1 and MT2 receptor agonist and a serotonin 5-HT2c receptor antagonist. Melatonin medications are used in the prevention and treatment of sleep disorders, insomnia, all forms of distress, affective disorders, especially seasonal affective disorder, arterial hypertension without a night lowering of blood pressure, cerebrovascular disorders, other vascular disorders, especially in elderly and elderly people. These drugs are also used to facilitate adaptation during the change of time zones, in the prevention of tumor diseases, stimulation of immunity, endocrine disorders, menstrual disorders, metabolic disorders. Adverse reactions to melatonin medications are rare and are manifested by feelings of discomfort in the stomach, headache, sometimes depression. When taking melatonin medications for 4-6 hours before the start of work, attention, the speed of physical and mental reactions, and the coordination of movements can be reduced, which requires caution for drivers and other operators of the operator. At the time of melatonin medications taking should refrain from drinking alcohol and smoking. Contraindications are limited and concern pregnancy, lactation, children under the age of 12 years. It should be remembered that acetylsalicylic acid, beta-adrenergic receptor blockers, sedative antidepressants, tranquilizers and other soothing drugs can reduce the level of melatonin in the body and lead to a decrease in the therapeutic effect expected from the use of it and similar preparations. Melatonin medications open new opportunities in clinical practice, which are yet to be mastered, but which, undoubtedly, will contribute to achieving higher results in the treatment of patients with a variety of somatic diseases. With these medications, we enter the age of chronomedicine, having received real tools for optimizing human biological rhythms as a necessary condition for restoring and preserving the health of our patients.

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