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Re: agomelatine/Valdoxan » tensor

Posted by SLS on January 15, 2012, at 9:16:50

In reply to Re: agomelatine/Valdoxan » SLS, posted by tensor on January 15, 2012, at 9:01:54

> > Valdoxan (agomelatine) didn't like me. It made me feel worse. I do know someone for whom Valdoxan was the key to his remission from ultra-rapid cycling bipolar disorder. I do know that Valdoxan will not work to produce sleepiness in him. It does not act as a hypnotic. He often stays up late to do work. I could not predict how well it would work for you.
> >
> > Does melatonin have any effect on you?
> >
> >
> > - Scott
>
> Hi Scott!
>
> Never tried melatonin. I'm more interested in its strong 5-HT2C antagonism, maybe it can lift my depression enough to let me work again. Not sure how well it would work with Remeron (synergy?) and Abilify though.


Valdoxan is definitely worth a try. Certainly the 5-HT2c antagonism can help with depression, and the melatonin receptor antagonism might improve sleep quality.

Good luck!


-----------------------------------

« PreviousEuropean Neuropsychopharmacology
Volume 16, Supplement 5 , Pages S639-S643, September 2006
Depression and associated sleep disturbances: patient benefits with agomelatine

David J. Kupferemail address

Abstract
Abstract + References
PDF
References

Summary

The essential linkage of sleep disturbance and clinical depression has long been recognized. Almost all patients with major depression report some form of sleep difficulty including insomnia, oversleeping, and poor-quality sleep. Some have argued that these changes in the sleep-wake cycle are actually aspects of a more fundamental alteration in circadian rhythms. Antidepressants that reduce restless sleep and awakenings and improve daytime alertness are desirable. It also appears that compounds that rearrange the intensity of rapid eye movement and slow-wave sleep may provide the best clinical effects on sleep besides antidepressant clinical efficacy. Agomelatine, a new antidepressant with melatonergic activity and 5-HT2c antagonist properties, has shown its efficacy in major depression. Beyond this antidepressant efficacy, agomelatine demonstrates sleep electroencephalographic changes consistent with desirable sleep architecture improvements, as well as improved subjective sleep quality within the first week of administration accompanied by an improvement in daytime alertness.


---------------------------------------

Int Clin Psychopharmacol. 2007 Oct;22 Suppl 2:S21-5.

High-quality remission: potential benefits of the melatonergic approach for patients with major depressive disorder.

Lam RW.

Division of Clinical Neuroscience, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. r.lam@ubc.ca
Abstract

Full remission of symptoms is the goal for the acute treatment of depression, because incomplete remission is associated with poor outcomes including higher risk of relapse and chronicity. The current definitions for remission (e.g. a score of </=7 on the Hamilton Depression Rating Scale), however, allow for the presence of residual symptoms of depression even if remission is attained. The focus now is on the quality of remission, that is, ensuring a minimum of such residual symptoms, because the consequences of low-quality remission also include impairment in psychosocial functioning. The most common residual symptoms are sleep disturbances, fatigue, and disinterest. Sleep-associated residual symptoms are particularly common, and are a major concern because most current treatments fail to adequately address sleep disturbances and may even aggravate them. Other side effects of current treatments, such as weight gain and sexual dysfunction, may also reduce the quality of remission. A novel approach to the treatment of depression with agomelatine, a melatonergic MT1 and MT2 receptor agonist and 5-HT2C receptor antagonist, may be an effective treatment that improves the quality of remission, as it combines good efficacy with positive effects on sleep, neutral effects on sexual function, and a favorable side effect profile.

PMID:
17917563
[PubMed - indexed for MEDLINE]

- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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poster:SLS thread:1007290
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