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Regarding Agomelatine...

FunkOdyssey's Photo FunkOdyssey 19 Oct 2010

Yeah... after 4 weeks on 50mg, here's what I notice:

Improved circadian rhythm / sleep
irritable
confrontational
road rage

No positive changes in any of these areas:

mood
motivation
libido

Can't see myself paying $120/month for this. I'm revisiting an old favorite next (bupropion) in combination with another old favorite (dexmethylphenidate).
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aLurker's Photo aLurker 19 Oct 2010

Yeah... after 4 weeks on 50mg, here's what I notice:

Improved circadian rhythm / sleep
irritable
confrontational
road rage

No positive changes in any of these areas:

mood
motivation
libido

Can't see myself paying $120/month for this. I'm revisiting an old favorite next (bupropion) in combination with another old favorite (dexmethylphenidate).

Thanks for sharing your experience.

Interesting combination you're considering and obviously relevant to my own interests. From your previous posts I'm guessing bup for motivation and d-mph for focus. Why not bup and memantine instead? What's your reasoning from a pharmacological stand-point since both bup and d-mph are dopamine and norepinephrine reuptake inhibitors? Aren't the overlapping effects an issue?
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medievil's Photo medievil 19 Oct 2010

bup is just a NRI, it doesnt significantly raise dopamine.


Funk, why did you stop the perika, memantine, dexedrine combo, or do you prefer focalin to it?
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FunkOdyssey's Photo FunkOdyssey 20 Oct 2010

bup is just a NRI, it doesnt significantly raise dopamine.


Funk, why did you stop the perika, memantine, dexedrine combo, or do you prefer focalin to it?


I prefer the initial effects of dexamphetamine, however with any type of continuous use it seems to "crack me out". I get this burnt out kind of feeling where I'm stimulated and focused but cognitively useless and can't really think straight. It doesn't feel healthy and I'm not productive in that state. Dexmethylphenidate seems to be gentler on me in this respect, and thus more sustainable for long-term use, albeit less motivating. That's where bupropion will come in though.

I'm off everything serotonergic for now. I needed SJW/SSRI mainly for panic/physical anxiety and I think other changes I've made to my regimen (mainly a bunch of anti-inflammatory supps) have improved this. If I start feeling it again though with bupropion/dexmethylphenidate I will probably start 2.5-5mg of escitalopram, which more effectively deals with that particular symptom than SJW.

Interesting combination you're considering and obviously relevant to my own interests. From your previous posts I'm guessing bup for motivation and d-mph for focus. Why not bup and memantine instead? What's your reasoning from a pharmacological stand-point since both bup and d-mph are dopamine and norepinephrine reuptake inhibitors? Aren't the overlapping effects an issue?

You basically have it right, bupropion for motivation and dexmethylphenidate for focus. D-MPH is biased toward inhibition of DA reuptake over NE, the only psychostim I know of with this property. I think that makes it uniquely suited to combine with bupropion which is primarily an NE releaser, NOT reuptake inhibitor (PMID: 12826985, 11374336). The combination should be similar to amphetamine except without potential neurotoxicity, and with the bonus of a sustainable and effective antidepressant effect which amphetamine does not provide. From what I've read, the bupropion should greatly reduce or eliminate any crash from the dexmethylphenidate in the evenings.

Why not memantine: I don't really trust it. I find that when I'm taking it, I tend to blame it for anything that goes wrong. This is a little hard to explain and probably not entirely rational. I find it mysterious and weird and I have a hard time pinning down its effects, which bothers me.

I expect the motivating effects of bupropion will not be maintained at their initial intensity but I don't think they should disappear entirely long-term.
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marky999's Photo marky999 31 Oct 2010

Hello

Am converting from lexapro (escitalopram) to valdoxan. I have been on SSRIs for the last 5 years for Seasonal Affective Disorder.

I was put on 5 mg lexapro initially (after my normal 100mg Sertraline) until I saw a psychiatrist.

Saw psychiatrist and was prescribed 25 mg Valdoxan.

Straight swap, no tapering (not sure how I would taper with 5mg lexapro?)

First week was great. Slow improvement on mood and on anxiety. Started to get brain zaps though :-(
Started to feel so much more social etc.
I had to take 50mg Sertraline as couldn't cope with brain zaps :-(

Now nearly week 2 of Valdoxan, I have not had anymore Sertraline since week 1.

Brain zaps are back, along with anxiety and low low mood :-(

Can't quite work out what's going on ? think my SSRI withdrawal is fighting against my Valdoxan treatment ???

Please help :-(

Do I continue through the withdrawal ? Or do I ask dr to be put back on 5mg lexapro to calm my receptors down ??
I'm so annoyed that as I was starting to feel so much better at the first week of Valdoxan.

Its been over a week now with zero SSRIs and it's driving me mad :-(

I think Valdoxan is trying to work, but the SSRI withdrawal is maybe hiding it ??

Any advice would be lovely.

Marky Mark
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Animal's Photo Animal 31 Oct 2010

You should be tapering off the SSRI while continuing the Valdoxan treatment; you can break apart tablets if you need to.

If it truly is SAD that you are suffering from would it not make sense to make this transition during the summer?
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marky999's Photo marky999 31 Oct 2010

You should be tapering off the SSRI while continuing the Valdoxan treatment; you can break apart tablets if you need to.

If it truly is SAD that you are suffering from would it not make sense to make this transition during the summer?



Thanks for the reply :-)

Yes it would make complete sense to me ! my psychiatrist on the other hand wanted to do it now, I have been off work for the last nearly 2 months and just want to get back to my old self again. I feel as if doing a straight swap from one to the other is just making things worse :-/ especially when I started to have positive results at the start of the Valdoxan treatment.

I have given up and taken a very small dose of SSRI, so will see how that goes. I just can't continue feeling like this, I'm happyish one minute then low and snappy the next, and also having brain zaps, being snappy, moody, angry ! it's so not me !

In the summer, I will slowly taper off the escitalopram 5mg ( I know it's not a huge dose, but having been on SSRIs for the last 5 years my brain just can't cope going cold turkey).

Thanks for reply again, it makes a huge difference.

Marky Mark
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Animal's Photo Animal 31 Oct 2010

You should be tapering off the SSRI while continuing the Valdoxan treatment; you can break apart tablets if you need to.

If it truly is SAD that you are suffering from would it not make sense to make this transition during the summer?



Thanks for the reply :-)

Yes it would make complete sense to me ! my psychiatrist on the other hand wanted to do it now, I have been off work for the last nearly 2 months and just want to get back to my old self again. I feel as if doing a straight swap from one to the other is just making things worse :-/ especially when I started to have positive results at the start of the Valdoxan treatment.

I have given up and taken a very small dose of SSRI, so will see how that goes. I just can't continue feeling like this, I'm happyish one minute then low and snappy the next, and also having brain zaps, being snappy, moody, angry ! it's so not me !

In the summer, I will slowly taper off the escitalopram 5mg ( I know it's not a huge dose, but having been on SSRIs for the last 5 years my brain just can't cope going cold turkey).

Thanks for reply again, it makes a huge difference.

Marky Mark


Well what you have to remember is that Valdoxan is one of the most benign antidepressants in existence; you can combine it with virtually anything and have no extraneous side effects. It's mechanism of action is also very subtle from a psychoactive perspective, and therapeutic effects gradually build up over the course of 6-8 weeks. You have to make a very objective assessment of any apparent change in symptoms at this point to know if it's helping.

So even if you have to combine it with the escitalopram indefinitely until the ideal time to taper presents itself; don't worry about any possible negative interactions. :happy:
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nupi's Photo nupi 28 Jan 2012

Does anyone have any long term experiences with Agomelatine? Had a discussion with a shrink yesterday what to do about lack of motivation/fatigue (the initial reports sound stellar). Told him I would not go the SSRI route, he wanted to put me back on Wellbutrin which I dislike because it wreaks havoc with my stomach. Discussing some other options (he did not like the MAOI idea and said he , he came up with Agomelatine which seems interesting (not the least for managing sleep) but he also insists on regular liver function tests (which is a pain because I travel a lot)...
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nupi's Photo nupi 30 Jan 2012

*bump* Anyone?
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evodude's Photo evodude 30 Jan 2012

I started upping my agomelatine dose to 50mg also. One of the reasons is because of the memory consilidation effect and 25mg wasnt doing anything for the mood. I noticed a trmendous boost of energy. Bodymovement has never been lighter, actually no effort. Finally i feel something on the mood part. Only drawback is that i cant seem to get out off bed. I slepped 12hours this last saturday... Hope this will disappear over time.
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nupi's Photo nupi 31 Jan 2012

How long have you been on it? There is no way I can afford 12h of sleep...
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evodude's Photo evodude 02 Feb 2012

50mg a week now. Good news is that now my sleeping clock become normal. And i awake clearheaded and rested as never begore. Big thumbs up
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gizmobrain's Photo gizmobrain 24 Sep 2012

I've been looking at agomelatine and amisulpride. Both don't seem to be available in the US.

If anyone in the US has any lying around, PM me.
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protoject's Photo protoject 09 Nov 2012

50mg a week now. Good news is that now my sleeping clock become normal. And i awake clearheaded and rested as never begore. Big thumbs up


This sounds great. Did you have any sleeping problems before?

I have serious sleeping problems [probably the major problem of my entire life] and am finally considering agomelatine after a long time of being scared of it. Reason I am scared of it is because I thought, maybe because it's a melatonin agonist, it will downregulate my melatonin receptors. [Melatonin used to work pretty good for me, then after that no matter what it made things worse instead].

Can someone please PM me your best sources of agomelatine [online sources], looking for good quality but also good price obviously, I've spent so much money on supplements and medicines it's not even funny. If anyone has some spare agomelatine they're willing to share then I'd also be enthusiastic to be the beneficiary.

Also can more people please comment on agomelatine's effect on sleep? I'd prefer responses from people who actually have sleeping problems to begin with , such as general insomnia, difficulty getting to sleep, difficultly with sleep maintanenece, waking up and not being able to get to sleep, low sleep times, etc. but I'll take everything I can get.
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magniloquentc0unt's Photo magniloquentc0unt 02 Mar 2013

do you think this could be helpful if i have hypersomnia? i know it sounds stupid, but the hypersomnia might be due to bad sleep.. and the daily fatigue, the same...
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prunk's Photo prunk 02 Mar 2013

I had a 7 (or was it 8) day trial with agomelatine. Not sure did I sleep any better during the trial but the daily fatigue was severe. I was almost like paralyzed; just sat and waited for the evening to come. Also gained weight at least 2,5kg during that time. So, no more agomelatine.
Edited by prunk, 02 March 2013 - 09:52 PM.
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xeon's Photo xeon 28 Apr 2013

50mg a week now. Good news is that now my sleeping clock become normal. And i awake clearheaded and rested as never begore. Big thumbs up


This sounds great. Did you have any sleeping problems before?

I have serious sleeping problems [probably the major problem of my entire life] and am finally considering agomelatine after a long time of being scared of it. Reason I am scared of it is because I thought, maybe because it's a melatonin agonist, it will downregulate my melatonin receptors. [Melatonin used to work pretty good for me, then after that no matter what it made things worse instead].

Can someone please PM me your best sources of agomelatine [online sources], looking for good quality but also good price obviously, I've spent so much money on supplements and medicines it's not even funny. If anyone has some spare agomelatine they're willing to share then I'd also be enthusiastic to be the beneficiary.

Also can more people please comment on agomelatine's effect on sleep? I'd prefer responses from people who actually have sleeping problems to begin with , such as general insomnia, difficulty getting to sleep, difficultly with sleep maintanenece, waking up and not being able to get to sleep, low sleep times, etc. but I'll take everything I can get.


I would also like to know how Agomelatine affects sleep in the long term.
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evodude's Photo evodude 28 Apr 2013

<deleted>
Edited by evodude, 28 April 2013 - 09:30 AM.
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nowayout's Photo nowayout 28 Apr 2013

You should be tapering off the SSRI while continuing the Valdoxan treatment; you can break apart tablets if you need to.

If it truly is SAD that you are suffering from would it not make sense to make this transition during the summer?



Thanks for the reply :-)

Yes it would make complete sense to me ! my psychiatrist on the other hand wanted to do it now, I have been off work for the last nearly 2 months and just want to get back to my old self again. I feel as if doing a straight swap from one to the other is just making things worse :-/ especially when I started to have positive results at the start of the Valdoxan treatment.

I have given up and taken a very small dose of SSRI, so will see how that goes. I just can't continue feeling like this, I'm happyish one minute then low and snappy the next, and also having brain zaps, being snappy, moody, angry ! it's so not me !

In the summer, I will slowly taper off the escitalopram 5mg ( I know it's not a huge dose, but having been on SSRIs for the last 5 years my brain just can't cope going cold turkey).

Thanks for reply again, it makes a huge difference.

Marky Mark


Well what you have to remember is that Valdoxan is one of the most benign antidepressants in existence;


except apparently on the liver.
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nowayout's Photo nowayout 25 Aug 2013

Finally I'm copying and pasting this from the psychonauts group (Hope the guy - 'nobrainer' doesn't mind.


Does anybody know how to find the agomelatine-related psychonauts group? This group does not seem to be actually findable via Google, never mind searchable.
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spookytooth's Photo spookytooth 28 Aug 2013

I took Agomelatine for around 2 months in the dose of 25mg and then 50mg. I observed neither positive nor negative effects
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xeon's Photo xeon 08 Sep 2013

How much does Agomelatine cost? I am going to see my therapist/nurse practitioner soon and want to ask about this medication because I am very reluctant to take any Serotonin altering med because of the side effects, but I don't think my insurance will cover this medication. I don't know anything about "online pharmacies"... can you actually get legitimate medications there?
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nowayout's Photo nowayout 08 Sep 2013

In SA it was about the equivalent of $60 for a 4 week supply at 25mg per day.
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xeon's Photo xeon 08 Sep 2013

SA?
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nowayout's Photo nowayout 08 Sep 2013

South Africa. I expect the prices would be comparable elsewhere.
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chemicalambrosia's Photo chemicalambrosia 08 Sep 2013

How much does Agomelatine cost? I am going to see my therapist/nurse practitioner soon and want to ask about this medication because I am very reluctant to take any Serotonin altering med because of the side effects, but I don't think my insurance will cover this medication. I don't know anything about "online pharmacies"... can you actually get legitimate medications there?


It never fully went through FDA channels to get approved. It isn't available legitimately in the US... you have to order it from online pharmacies. Some online pharmacies are complete scams, others sell completely legit brand name medicines. This is a legit source, but it is pretty expensive:
http://brandmedicine...roducts_id=1120

There is probably an Indian pharmacy that carries a generic for cheaper, but I'd be wary of giving them my credit card number since a number of them have had payment security problems. If you find one check its reputation and possibly get a disposable credit card so you don't have to worry about their payment security.
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nowayout's Photo nowayout 08 Sep 2013

There is probably an Indian pharmacy that carries a generic for cheaper, ...


No I haven't found any generics for agomelatine, not even in India.
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xeon's Photo xeon 08 Sep 2013

Interesting.. are there no legitimate alternatives to Valdoxan that can be obtained in the U.S.? Something that has a similar action on the 5-HT2C receptors? I think Mirtazapine does, but it also sedates...
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