Opinions on Agomelatine

[thp]

Hi all,

About two years ago, I became very active with regard to fitness and fat loss. I've made good progress and want to continue that way.

I also suffer from depression but have avoided antidepressants so far, because of the wealth of evidence (usually anecdotal) about weight gain, fat loss stalls, sexual side effects etc.

I've been prescribed Agomelatine as my first AD because my depression has become severe. I'm told it has few of the side affects usual for SSRIs etc.

On researching the drug, I see it works on Melatonin and is an antagonist of the 5HT2c receptors. I'm worried....

Melatonin and associated drugs (Ramelteon for e.g.) are reported to sometimes decrease Testosterone and increase Prolactin. No good for a fitness enthusiast.

5HT2c atagonism is associated with weight gain.

Neither of these side effects are listed in the drug information.

Does anyone have experience of this drug or educated opinion? It's been suggested the 50mg dose would be best as it has even lower sexual side effect profile than placebo.

Big thanks to anyone who can help.

 

[Tripman]

As far as I know agomelatine is easily one of the SSRI's with the least side effects.

Personally I have never had any problem with weight gain on AD's only on anti-psychs.

If you don't get any good replies to this I might try it out in healthy living or something. I'll think on it.

 

[effie]

I have things to say. Just not right now, too sleepy... tomorrow though, promise

 

[thp]

I look forward to that Effie.

Anyone else have input too?

 

[Tripman]

I can tell you that it is fantastic at increasing slow wave sleep? 8(

 

[effie]

Okay. So I don't know lots about this, and it is a very atypical antidepressant, but from what I know it certainly does seem to have fewer side effects that SSRIs and there have been several high-quality randomised controlled trials which have shown it to be very effective, and earlier on than most antidepressants (1-2 weeks rather than 3-4). None of the studies I found showed weight gain to be an issue, so I wouldn't worry too much about this - especially if you are an active, athletic person. If you do notice it becoming a problem then you can always discuss it with your doctor..

The same with the decrease in testosterone/increase in prolactin - theoretically it is possible, but this has not been an issue that has cropped up in any of the studies I have read so hopefully it won't be a problem for you.

Sorry, I was hoping to be more helpful than that hah.. couldn't find as much literature as I hoped. Basically, so far it looks like a pretty effective antidepressant, especially for major depressive disorder and anxiety, with very few side effects, and as Trips said it has the added benefit of helping to reset circadian rhythms and restore good-quality sleep without making you feel drowsy or lethargic in the daytime. Average doses in trials seem to be 25-50mgs, so if you are concerned you could start at 25mgs maybe and see how you go? I would have a chat with your doctor about this...

 

[NeighborhoodThreat]

I'm going to move this to the Healthy Living forum, it's sort of in a grey area between BDD and HL but we'll see how it does there.

BDD --> HL

 

[euphoria]

I don't know much about Agomelatine, but I can offer advice about the medication I take. I, too, feared and avoided taking ssri's for a very long time, despite the mental suffering I learned to live with. I have always been extremely active and keep myself in shape, and the weight gain side effect is what scared me off.

Finally I broke down and couldn't take it anymore, and decided it was worth it just to try. Let me tell you, it saved my life. I didn't have nearly the side effects I thought I would have. I had a few at the beginning.... such as slight urinary retention, trouble sleeping, and drowsiness. But all of those went away after a month or so. I have had absolutely no sexual side effects from it. I gained a bit of weight, but it wasn't anything drastic. And I tend to account the slight weight gain to personal habit changes rather than the actual medication making me hungrier.

My point is, every medication affects every person differently. It interacts with your individual brain chemistry. So what may give one person lots of nasty side effects might not give you any, or only gives you a very slight one that you can learn to live with or it fades over time. The quality of life was worth it to me, so if you're at the end of your rope, just keep an open mind. You might be surprised.

 

[thp]

Thanks everyone.

Euphoria - what did you take?

 

[euphoria]

zoloft (sertraline)

I've read and been told by my doc that it is a weight-neutral ssri. Even if you do gain some weight, studies have shown that it's generally only a few pounds. I'm digging up that link now...


Weight Gain "neutral" ssri's
http://www.mayoclinic.com/health/antidepressants-and-weight-gain/AN01396

Possible reasons why the weight gain occurs, and typically how much weight is gained
http://www.livestrong.com/article/186099-why-do-people-gain-weight-on-ssris/


Another thing to think about is that you don't have to be on an ssri for very long. 6 months to a year is a reasonable time. I am telling you this because it had such a dramatic positive affect on my quality of life, and while I am considering going off of it soon, I also consider it to have been a good decision. I hope that you have a positive experience as well!