![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by tensor on January 15, 2012, at 8:30:17
What are you experiences with Valdoxan? Thinking of switching escitalopram for Valdoxan. Mostly for AD effect but also because I have to take 100mg of Seroquel for sleep now and I don't want to. I have a partial response from Remeron and Abilify.
Thanks.
Posted by SLS on January 15, 2012, at 8:51:24
In reply to agomelatine/Valdoxan, posted by tensor on January 15, 2012, at 8:30:17
> What are you experiences with Valdoxan? Thinking of switching escitalopram for Valdoxan. Mostly for AD effect but also because I have to take 100mg of Seroquel for sleep now and I don't want to. I have a partial response from Remeron and Abilify.
>
> Thanks.
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
Posted by tensor on January 15, 2012, at 9:01:54
In reply to Re: agomelatine/Valdoxan » tensor, posted by SLS on January 15, 2012, at 8:51:24
> 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?
>
>
> - ScottHi 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.
Thanks.
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 agomelatineDavid J. Kupferemail address
Abstract
Abstract + References
ReferencesSummary
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
AbstractFull 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
Posted by tensor on January 15, 2012, at 9:27:53
In reply to Re: agomelatine/Valdoxan » tensor, posted by SLS on January 15, 2012, at 9:16:50
Posted by SLS on January 15, 2012, at 9:47:22
In reply to Re: agomelatine/Valdoxan » tensor, posted by SLS on January 15, 2012, at 9:16:50
Oops. I misspoke.
> melatonin receptor antagonism might improve sleep quality.
Should be *agonism* and not antagonism.
Sorry.
- Scott
Posted by Phillipa on January 15, 2012, at 10:09:29
In reply to Re: agomelatine/Valdoxan - Oops - Error, posted by SLS on January 15, 2012, at 9:47:22
I read a post this morning where lexapro low dose can cause depression when quitting which I've never heard it was compared with this med and evidently if this is ago was superior. Phillipa
Posted by sigismund on January 15, 2012, at 12:05:59
In reply to agomelatine/Valdoxan, posted by tensor on January 15, 2012, at 8:30:17
>What are you experiences with Valdoxan?
I took it for a couple of years. It can be hard on the liver but is relatively tolerable. I loved it at first, but over time the sleep improving qualities became less pronounced and the 5HT2C blocking effect became more dominant.
>Thinking of switching escitalopram for Valdoxan.
You can take them together, I think?
Start low on the Valdoxan. I should have spent longer on half a tablet a day. I could have saved myself some anxiety.
Posted by tensor on January 15, 2012, at 12:28:56
In reply to Re: agomelatine/Valdoxan » tensor, posted by sigismund on January 15, 2012, at 12:05:59
> I took it for a couple of years. It can be hard on the liver but is relatively tolerable. I loved it at first, but over time the sleep improving qualities became less pronounced and the 5HT2C blocking effect became more dominant.
How hard is it on the liver? How good was it for your sleep? How did the 5-HT2C blocking affect you?
> You can take them together, I think?Yeah, but I don't want to take too many meds at a time, don't know if escitalopram is doing anything for me.
> Start low on the Valdoxan. I should have spent longer on half a tablet a day. I could have saved myself some anxiety.Thanks, I'll keep that in mind, gonna call pdoc tomorrow morning and see if he agrees to start me on Valdoxan.
Posted by sigismund on January 15, 2012, at 12:51:14
In reply to Re: agomelatine/Valdoxan » sigismund, posted by tensor on January 15, 2012, at 12:28:56
>How hard is it on the liver?
You are supposed to have your liver enzymes checked. Mine were OK. It has this terrible taste. Not bitter or anything....just like you should not be consuming it. I know this because I experimented with taking it under the tongue.
>How good was it for your sleep?Very good at first. Not at 25mg though. My first dose was 25mg and I woke after an hour and that was it for the night. It felt something like a smart drug to begin with. I continued with half a tablet a day and it was very good. After a couple of months I pushed it to 25mg/d which was a mistake for me. It gave me significant afternoon anxiety which eventually dissipated. Over time the melatonergic effect became less obvious and I felt it was not helping my sleep at all. It is naturally bad anyway.
>How did the 5-HT2C blocking affect you?Something of a dopaminergic feel, sex and so on. And that afternoon anxiety I mentioned
Posted by tensor on January 15, 2012, at 12:55:45
In reply to Re: agomelatine/Valdoxan » tensor, posted by sigismund on January 15, 2012, at 12:51:14
> Something of a dopaminergic feel, sex and so on.
How about energy and interest? Or just nausea and fatigue?Okay, do you think it's worth a shot?
Thanks.
Posted by alchemy on January 15, 2012, at 13:01:35
In reply to Re: agomelatine/Valdoxan » sigismund, posted by tensor on January 15, 2012, at 12:55:45
I can't remember his name here, but he had great success on it for his ultra-rapid cycling. I tried, and it didn't make me feel so good & didn't help my cycling.
You might as well try it though.
Posted by sigismund on January 15, 2012, at 18:21:33
In reply to Re: agomelatine/Valdoxan » sigismund, posted by tensor on January 15, 2012, at 12:55:45
>How about energy and interest?
Ummmmm
Anything that gives you energy and interest sounds like it should be illegal.
>Or just nausea and fatigue?
Nope, none of that either.
>Okay, do you think it's worth a shot?
Yes
Posted by Phillipa on January 15, 2012, at 20:21:35
In reply to Re: agomelatine/Valdoxan, posted by alchemy on January 15, 2012, at 13:01:35
Alchemy was that poster Ron Hill? Phillipa
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.