Valdoxan or Agomelatine for Depression
Valdoxan or Agomelatine: A new depression treatment
About 40-50% of people taking the current antidepressants, or the SSRIs, stop treatment shortly after starting. This is because that class of medications has certain significant side effects, like nauseua and sexual dysfunction.
Valdoxan, generic agomelatine, is a new medication that is generating a lot of excitement because it seems to be an effective antidepressant that doesn’t have those problems.
Valdoxan is a synthetic analogue to melatonin, a natural substance your body has that plays a role in sleep regulation. Chemically, it serves to activate the melatonin 1 and 2 receptors, while also acting as an antagonist to 5-Ht2. This latter activity may serve to promote release or norepinephrine and dopamine.
It’s important to note that Valdoxan has significantly different chemical action than the selective serotonin reuptake inhibitors (SSRIs).
Possible Advantages
Valdoxan may not have the same rate or degree or type of side effects as traditional antidepressants. It may not cause nausea, sexual dysfunction and other common side effects.
It may start working faster, with some efficacy observed at just two weeks, not the four typically needed for antidepressants.
Both these elements may mean that people will be less likely to want to stop taking it and could start expereincing benefit at an earlier time. In some studies, only 15% stopped use of Valdoxan, which is much less than the rate traditional antidepressants have.
This may mean a very significant advantage over traditional treatment.
Concerns
Several studies of Valdoxan have not shown significant advantage over placebo.
Because Valdoxan is heavily metabolized by the liver, people with some form of liver damage may experience toxicity. One study showed that some degree of liver impairment could lead to a 50-fold increase in drug concentration.
Valdoxan may, like the SSRIs, increase risk of suicidal ideation.
Efficacy
The number one question people have about any medication is, how well does it work? It appears that there have been 7 major studies to date which have analyzed the efficacy of Valdoxan for treating depression, and there are others going on to see if it works for generalized anxiety disorder and other conditions.
Positive studies
One study showed that Valdoxan was significantly more effective as a treatment for depression than Prozac.
A study of 711 people treated for depression showed that it was significantly better than placebo and had effect starting at 2 weeks. Additionally, that study showed that severely depressed people were more likely to respond to Valdoxan than to Paxil.
Another study of 238 people showed a roughly 55% response rate versus 35% response to placebo.
Negative Studies
Several have also shown little or no benefit over placebo. An unpublished 6 week long study of 414 patients showed that Valdoxan had a response in 53% of those taking it compared to 47% who responded to placebo. That same study showed that Prozac did have a significant response.
And another 6 week long study of 607 patients showed that neither Valdoxan or Prozac had benefit for treating depression over placebo.
What it means
Valdoxan is not free from the problems that typical antidepressants have, that sometimes they don’t seem to work much better than placebo. The studies seem to indicate that it is about as effective as traditional antidepressants while having significantly less side effects and possibly faster onset of action.
These advantages may make it extremely popular. That said, the concerns around its metabolism have yet to fully be addressed, and there may be other issues that time will reveal.
Antidepressants
There is a lot of controversy around antidepressants. Antidepressants – the Pros and Cons looks at both sides of the story.
Treatment Resistant Depression
Sometimes depression does not respond to treatment. Here we present 10 ideas for Treating Treatment Resistant Depression.
Dealing with Anxiety
Depression and anxiety tend to come together. See The Top 25 Anxiety Tips for ideas on how to deal with anxiety.
I’m in my ninth week of treatment with Agomelatine, and unfortunately i have to say that i’m disappointed. At first i thought it was fantastic. I was on Zoloft for two months when i found out that Ago is available in UK, so i rushed to my GP for prescription for it and to my surprise she gave it to me. So i’ve quited Zoloft immediately, waited 2 days and started taking Ago 25mg before bed as prescribed. Maybe there was some kind of improvement in sleep, definitely the first couple of days but nothing dramatic as some of the clinical trials participants reported. What i definitely noticed in the first 1-2 days(and only then) was the clearness of mind, it was like someone striped me of all this bullshit thoughts and preconceptions that cause my depression, anxiety . I could see the world and matters as they really are. To good to be true, and it was to good, it started to shade off day by day, even the sleeping benefits started to decline. Also i noticed some hair lose but wasn’t sure it started before or after Agomelatine, i decided to continue.
So when i had last 6 of the 28 tablets left i decided to upper the dose to 50 mg(2 tabs before bed). Nothing happened in those 2 days on 50 mg, not even sleep improvement. I didn’t have a chance to test this dose longer cause my doc refused to prescribe me this dose reasoning it is new and untested in real life med, i don’t blame him. Ok so i was back on 25mg and… again first few days very good feeling, clear mind, just as at the beginning of the treatment, then few more days and back to normal. Some three days ago i started having annoying repetitive thought while trying to fall asleep, hair lose continues, headaches towards the end of the days, no anti depressive or anxiolytic effects whats so ever and it’s been 45 days!!!! Today i decided to stop it and BACK TO SSRI’s.
conlusion: I’m sure it will work for some and not for others, it doesn’t for me, i’m a good responder to ssri’s. When i’ve read headlines of some articles about Agomelatine : “BETTER THAN PROZAC” etc,. i had high hopes, but it’s not.
Rob
Lotna22@yahoo.co.uk
Dammit!
I just spent ages typing a long comment, but when I tried to send it my Internet Explorer did something really weird.
Did you get it or do I need to retype the whole thing?
If it hasn’t been posted yet, then likely we didn’t get it – sorry. But would appreciate your taking the time to rewrite it =)
I too had high hopes, having tried several SSRIs, each with vile side effects and even worse withdrawal effects. I was stuck on Prozac (some help with my anxiety disorder, negligible effect on my phobias but with the brain flashes, nausea etc making it not the ideal medication for me). On the plus side, initially I experienced excellent sleep and I have to say a much improved sleep pattern still, including increased ability to wake up in the morning. Apart from that, after 4 months, I am resigning myself to disappointment AND a suspicion that it is actually causing depression. Has anyone else experienced this? I haven’t shown what I would consider signs of true depression up to now in my life but lately I feel constantly tearful, have periods of nothingness, am lethargic and generally have no will to get myself out of this. It’s like a personality change.
I have been on agomelatine and since starting it I have had extreme nausea, hair loss, stomach aches and diorrhea, I have decided to stop taking it as the side effects out weighed any of the benefits I was told it would have, and am still waiting to see happen, which I guess i won’t see now I’ve stopped taking it.
I am currently in the sixth week of taking Valdoxan (25mg – 1 tbl.) I take it before bed time and despite promising gossip and all the fuzz about its superior efficacy it turned out to be a sugar pill for me. After six weeks I feel no anti depressive effect of any kind. Sleep is a bit deeper but that is everything there is for me from this medicine. I am really disappointed as I actually believed the manufacturer when they claimed on their website how superior this drug is over traditional drugs for treating depression.
Well, at least there are no side effects for me. I have heard of people who actually benefit from agomelatine (Valdoxan) but to roughly estimate, there are only about one third of them. I suppose there will have to be another anti-depressant drug in the future to call it magic.
regards from Slovenia
I have been on Agomelatine for about 5 weeks now-25mg. I was on Effexor for many years-finding it the best of a bad bunch. Coming off the Effexor nearly killed me, but I was on 450mg, a huge dose. Once getting the Effexor out of my system I was excited to feel more like me again after so many years-talking more, more energy and get up and go, not needing to have a nap every afternoon after work to survive the day. However I am finding the longer I am on Agomelatine I am getting more and more irritable-to the point where I am cranky with the kids and my husband all the time. I also seem to be winging all day and not happy with what my lot is in life.
Reading someones comment about their penis hurting made me remember in the first couple of weeks, the Agomelatine made me feel I had to masturbate all the time-I couldn’t even tell my doctor or my husband that one. It has settled down thank god, but now I’m finding for some reason if my husband touches me, I feel like my skin crawls. So not sure how long I will last on it. The gut irritation finally seems to have settles, but I have a constant sore throat and sore sinuses??? Anybodys experience of any of these would be greatly appreciated. Has anyone tried cymbalta? I know its very similar to Effexor, but I’m getting desperate for alternatives here.
I have been on various other medication for stress and anxiety I didnt think they were working the last I was on was Sertaline which made me feel calmer I no longer cried at nothing but I had no sex drive whatsoever which was very unusual for me then I developed this inane itching. My doctor prescribed Valdoxan telling me what a wander drug it was but that I was only the 3rd person in the practice to be prescibed it. I had great hope for it but I have been on it for over a week and I am so moody and irritable im forever breaking down and crying at the slightest thing the only up side I have is that my sex drive has returned as for the sleep I still take Tamazepam along side and im now having the most wierd or aggressive dreams to I continue with the medication will it get better ? I feel so low I would now say im very depressed, irrational, ilogical and just realy cant be bothered with anything
Hi all.
Started Valdoxan 25Mg, on second day now. Came off cymbalta 90mg with the mad headspin hooha. Had the runs & sore throat too. Cymbalta I thought was ok, I honestly don’t know anymore if any of them work.
My theory is I think way too much, maybe that’s why I’m depressed.. thoughts? Anyone else know what I mean?
I got in a depression in the end of 2009. My doctor gave me cymbalta, and I must say it worked wonderfully then, my appetite almost immediatly came back, and in my case it also almost immediately worked (I didn’t get into a real vital depression which I have had in 1993).
But when after two weeks (as prescribed) I increased to 60mg, I immediately got very depressed, so I stayed on 30 mg. In those days I just could go on with my job, and beside some dizzyness in the first days there where no side-effect. I stopped using it without problems about march last year (when spring was in the air again).
In nov. last year the same thing happened, and again cymbalta kept me out of the worst depression, but because my life now has been completely changed (much more problems!) it does not really solve my depression, neither did the additive light-therapie that I’ve just had.
Today my doctor prescribed me agomelatine, because my sleep pattern is not oke due to my deregulated life and the problems i have now and the ones that are to come in the near the future.
So I cannot say anything about that now, I’ve seen positif and negatif experiences, but I can only hope it will help me coming out of the depression/burn-out that I’m suffering of now.
(
Usually
I do not read too much about a medicine I take, but this seems to be a very modern medicine with relatively little side effects, so I got curious).
My word, my specialist psychiatrist is putting me on Agomelatine, but reading these comments I wonder if this is wise! Is there anyone out there that had a positive reaction from these tablets? I have had major depression since 2008, Welbutrin played havoc with my mind, then I went onto Molypaxin at night – wonderful, wonderful drug, but I need a daytime drug and have been on a few, with horrendous side effects, I was really hoping this wonder drug was going to be the answer!
I’ve been on agomelatine for well over a year now. Having suffered horribly with other SSRIs, I settled with Prozac for a few years despite the notorious electric brain shocks until I read about this wonder drug. I noticed no side effects whatsoever – after the initial wonderful sleep. Unfortunately I have to say I haven’t noticed any marked improvements in my anxiety and depression but I have noticed some improvements. This is enough for me to be content to continue with the drug rather than risk the horrendous side effects of yet another SSRI. I cope – and that’s better than a life of endless panic attacks. It’s worth a try at least. Good luck.
I took agomelatine at the beginning of 2011 and found it caused far too many side effects. I experienced dreadful pain in both my lower and upper digestive tract and my hair fell out at an alarming rate. While it did help with my sleep, it appeared to have no anti-depressant effect at all. I took the tablets for about 3 months before discontinuing. Now nearly 3 months later my hair is still falling out and the digestive issues are beginning to settle. It may work for some people but wasn’t right for me!
I have been taking Valdoxan for a month now. I never thought I could ever feel this good again after having severe depression and anxiety for the last 10 years.I still have to touble believing it is true.Hope it lasts. Hang in there guys maybe there is a god.
I’ve been taking Valdoxan 25mg for almost 3 weeks now and feel worse than ever; I have almost daily thoughts of self harm & suicide, am constantly irritable to the point that I can’t be around anyone. The one and only good thing I have experienced with this drug is that I sleep a little bit better than I did previously. Unfortunately this was the last drug I could try to my depression as none of the others have worked.
My wife has bipolar and after trying many AD’s to supplement lithium was put on Valdoxan 25mg by the psychiatrist. She is having a very serious reaction to it. Was stopped after 2 doses but 5 days later she is still in severe pain (she says it is worse than giving birth). The pain is back and stomach. She is also confused with poor balance, unable to write etc and is generally pretty incapacitated.
The psychiatrist has done basic tests – pulse, blood pressure, (both OK) blood test for lithium (result awaited, but he thought it unlikely to be the cause). He has done a severe reaction report. Currently she is taking pain killers + valium + sometimes alcohol to deal with the pain – this puts her out for a while. The drug will have long gone from her system so the worry now is has it done permanent damage. I’ve asked him to think of a plan B if there is no improvement soon.. Does anyone else have experience of this?
Hi my son has been depressed since been given contaminated anthrax shots in 1999 & 2001, al sorts of meds and mental hosp with ne relief, read about this med from uk called Agomelatine but reading pro & con about it, could somebody give the ok or no about it, he is desperate and so is his family, I can’t find address or co in uk that i can order it from, we are from us.
It’s academic now! My PCT has just ruled GPs can’t prescribe it any longer (the usual NICE reservations – sometimes have to speculate on their priorities, certainly not patient wellbeing). I had to come straight off it BUT not a single side effect – amazing. I noticed no difference for a couple of weeks and then was plunged into a maelstrom of emotions I haven’t had to face for a long while. Now what?
I have been taking 25mg of agomelatine nightly for seven months. I sleep much better and my depression/anxiety/panic attacks – for which I have been taking antidepressants since I was 19, I’m now sixty has almost vanished. My problem is the very painful ‘side effects’ I am experiencing with this medication. I have chronic back, muscle and joint pain to the extent that I can hardly walk some days. I have bouts of feeling severly cold and then at night feeling overwhelmingly hot. I have had all the blood tests and nothing has shown up to indicate what is causing these symptoms. So obviously it is the side effects of the medication. I have not experienced the sore throat, nausea or hair loss side effects that others have, however I do frequently suffer mild headaches. The side effects I am experiencing seem to come in cycles except for the severe muscle and joint pain which is with me most days. A Naturopath has given me a spray to squirt under my tongure which is to relieve the muscle and joint aches, and this works quite well in conjunction with Panadol Osteo, however nothing seems to help for any length of time to relieve the pain in my feet and ankles. I must stress that having had a number of antidepressants prescribed for me over the years I believe Valdoxan to date has given me the best results for my depressive illness. If anyone out there who has been taking Valdoxan and has been experiencing the same side effects as me and has been able to find someway of eliminating them PLEASE email me soonest.
I have been reading the above posts with much interest as I have had bi polar disorder for 22 since the birth of my twins and have been on every medication known to man and beast, I do not tolerate lithium and was wiped out by quetiapine.
I begged my consultant for something that would help me to setlle especially at night but did not want it to have the as i call it straight jacket effect, and something that would not affect my intellect so was given the ago with my mood stabiliser to try.. My experience to date (having been on it for 10 months) I was and remain impressed by the way it helps me to get to sleep and more important wake up not feeling doped up, I can also say that after about 3 months on the ago I started to socialise again and feel comfortable amongst my friends. I felt that I had found something that was both effective in settling and soothing my mood but also finding the old me again.
What I am now begining to realise is I have slipped into a cosy coccon and I am so content in this state that I am going ffrom day to day without going out getting washed or dressed and I have gained approx 2 stone through eating junk, I am quite tearful when watchng tv and seem to be developing an addiction to online bingo. I have tried to anaylse this behaviour all of it but feel calm and not in the least troubled by my current way of life. I feel the online bingo is my only stimulation and that is why it is becoming an issue. I know that I could go on like this as I feel as I have already said unpeturbed by it, howevr I am going to try and stop the ago and see if I can get some motivation back the problem here is I did take ago for three months previous to this 10 month course and experienced severe headaches so I am not looking forward to it :0( To the lady with the joint pain, I to am experiencing very similar symptoms and have been referred to see a specialist, I am 50 and I never consider the ago could be a cause I just put it down to getting older and sitting around doing nothing much at first but the pain got so much worse and I am now taking tramadol to try to cope with it, A very strange set of afairs and I am not sure that I would reccomend ago as I thought I would have when I first started taking it. I will take half of a 25 mg tablet tonight and tomorrow then stop it altogether and see how things are then.
@ GAYE
I also seem to be having a problem with my thermostat just I do not seem to feel cold and can overheat quite easily, I get a lot of comments that my house is freezing but I feel quite warm??
This is a follow up to my post in November. Sally had a urinary tract infection so the symptoms we assumed were from Valdoxan were not. She is now considering whether to try it again