Misc Valdoxan (agomelatine) melatonin agonist antidepressant. Thoughts and experiences?

[Psykoton]

Hello bluelighters!

I have recently been prescribed the antidepressant Valdoxan (agomelatine) 25mg / day, after trying almost all of the antidepressant drugs on the market (well, not really..) but Lexapro, Prozac, Zoloft , tricyclics and Cymbalta without success, and a lot of side effects. It is a melatonin agonist, and serotonin 5-HT2C antagonist. It is supposed to increase noradrenaline and dopamine, as well as resyncronize circadian rhythm and help with sleep.

Valdoxan is said to have less side effects than other antidepressants, but can be harsh on the liver, and liver enzymes should be checked every 6 week while on the drug (something my psychiatrist did not inform me about).

Have been on them for 2 weeks now, and I definitely feel more positive and not so tired during the day, but they interfere with my sleep, I wake up every second hour now, and have really vivid, colorful and strange dreams. They also give me a feeling of nausea in the morning, almost like a hangover, and migraine-like headaches. I hope that these side-effects will abate with time.

It is not approved by the FDA, but approved with some limitations in the EU. It it only allowed to be prescribed when at least 2 or more antidepressants have been tried without success, so it is a second to third-line drug, so to speak. Does anyone here have experience with Valdoxan? All input is appreciated !

 

[Psykoton]

Bump Anyone? (Mods, please move this thread to another subforum, if you think it is necessary).

 

[FnX]

I took it for several months but eventually had to stop because it's so bloody expensive. I found that it really helped with suicidal thoughts and increased my appetite (perhaps due to the 5HT2C antagonism). It wasn't the miracle drug I was hoping for but it really did help ease my depression. I found that it indeed did possess odd, miniscule stimulant properties, but only for a few hours after taking the drug, otherwise I didn't notice anything different with concentration for example. It could be that it made my paranoia worse in the long run though, I feel slightly less paranoid now that I'm off it.

Definitely didn't correct my terrible sleeping-patterns and I don't think it was really helping me sleep either, I used to wake up during the night sweating, anxious and generally overaroused a lot when I was on agomelatine. Liver enzymes were perfectly fine even with moderate alcohol use, but I wouldn't recommend drinking while on this medication because of liver issues.

No nausea or hangover for me. I found the drug a bit disappointing but I don't know why, it just felt very odd because there were so few side-effects. Anxiety-wise I felt worse off, except right after taking the drug maybe (for an hour or two). Didn't make me tired or anything... almost the opposite actually, after taking the medication I suddenly had a heightened desire to read stuff.

 

[FnX]

I'm probably getting back on agomelatine later this week, as long as my ALAT levels from the blood test turn out fine. There's one thing that a lot of here are unaware of and I felt is worth mentioning though. In addition to 5-ht2c antagonism, agomelatine also possesses significant 5-ht2b antagonistic properties too and possibly small/neglieble interactions with other serotonin receptors as well. I don't know why it's almost never mentioned anywhere, probably because we know very little about the 5-ht2b receptors themselves and therefore can't really attribute any therapeutical effects to this sort of activity. One other reason I can think of is that they want to market this drug as a very selective "melatonergic" medication.

Source:
http://www.ncbi.nlm.nih.gov/pubmed/12750432 - short abstract
http://jpet.aspetjournals.org/content/306/3/954.full.pdf - full thingy