# Starting Agomelatine (Valdoxan)



## shy-one (May 10, 2008)

Just started agomelatine and thought i'd keep a log.

Previously I had been on nardil for nearly 2 years with excellent results. However, due to weight gain (15kg), insomnia, afternoon lethargy, and weakness in the legs I had to come off. Since my final dose 1 month ago I have had horrible depression and severe anxiety. So that's when I decided to give valdoxan a try. 

One user here - zendog78 reported that agomelatine helped with the nardil withdrawal, and also helped his depression/anxiety a little (but not quite as much as nardil). Given that agomelatine increases dopamine, I thought perhaps it would be worth trying after nardil. 

Anyway, I took half a tablet last night (12.5mg). Strangely this actually made me sleep a little worse than usual (i've been sleeping like a baby since coming off nardil). I woke up briefly a number of times and also had very strange, vivid dreams. 

This morning my anxiety actually seems to be a bit less, but its hard to say because i've been fluctuating a lot since coming off nardil, so perhaps its just a good day. 

I heard you're also supposed to have liver tests? My doctor never mentioned this to me. Is this absolutely required on this medication? Has anyone else been on it without the tests? I don't drink or smoke, and have a reasonably healthy diet so i'm wondering if the risk would even be high in my case?


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## shy-one (May 10, 2008)

Took another half last night and slept better this time. Also on the first day I had stomach pains, like an unsettled stomach and burning sensation (was even more so after swallowing it). 

My IBS-D is also a lot better today, but can't say for sure if its due to this med.


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## Thorsten (Apr 6, 2010)

http://www.mindandmuscle.net/forum/40747-agomelatine-synergy-5-ht2c-mt1-2-a

Look for post number 6. This is my take on agomelatine.

If you can get through the first few weeks, the drug can be amazing for dysthymia and anhedonia.

I wouldn't know about its efficacy in comparison with Nardil (Nardil is the gold standard I believe, so, probably not as good).

I can tell you that agomelatine works, though. No doubt about it. Assess it after 6-8 weeks. Ignore those first few weeks (you'll doubtfully notice much, or, even may get some side effects).

I doubt your doctor mentioned the liver thing because 12.5mg is a paltry dose. The liver concerns were most notable at 50mg, and even then, it shoudn't be a problem for a healthy person. I suppose you could mention it to him if you're concerned?


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## shy-one (May 10, 2008)

I have actually been given 25mg dose, but just started with half a tablet for the first 2 days in case side effects were bad.

I doubt it will work though, as nardil is the only antidepressant that has ever worked for me (i've been on about 15 antidepressants over the past decade). 

Feeling very depressed and anxious again today.


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## shy-one (May 10, 2008)

Thorsten - have you been on this med yourself? If so, how does it compare to the SSRI's? SSRI's did absolutely nothing for me, I actually tried them all. 

I would never waste my time with an SSRI again, which is why I thought i'd at least give agomelatine a try. If this doesn't help then its straight back to nardil.


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## viper1431 (Jun 6, 2012)

I was never sure how well it would work for anything other than sleep. With it's half life of less than 2 hours you'd think it would be well and truly gone by morning.


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## shy-one (May 10, 2008)

viper1431 said:


> I was never sure how well it would work for anything other than sleep. With it's half life of less than 2 hours you'd think it would be well and truly gone by morning.


Apparently it does all its work in those 2 hours - increasing dopamine and norepinephrine.


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## shy-one (May 10, 2008)

Ok so this is my 7th day on agomelatine at 25mg.

Last night I woke up with insomnia (kinda like I used to with nardil, but not as bad) and definitely felt different, almost as if someone had flipped a switch in my brain. This was a similar feeling to when nardil first kicked in. 

Normally in the mornings I have been getting very anxious before work, then even worse during the day. Today was different, I felt MUCH less anxious and it was one of the first days since coming off nardil that I didn't need to take some valium just to get through the day at work. My depression also wasn't as bad.

I am not sure if its the real deal, or just a coincidence from having a better day. The only other thing I did differently was alter my dose of fish oil by taking 800mg of EPA at night and 400mg in the morning. Fish oil also increases dopamine, so I think it is a good add-on to this med. Previously I was taking 1200mg in the morning and 800mg at night which I think made my anxiety worse. 

I had very little hope for this drug, and didn't think it would work at all. I was even ready to call it quits and go back to nardil, but now i'm not so sure. I guess time will tell if it is actually working or not. 

So far I wouldn't say its as good as nardil, but still fairly decent. Much better than any SSRI for sure. Interestingly, I also started getting headaches as a side effect since yesterday (same day it may have kicked in). 

I really hope this is the real deal and things improve. 

For others that have been on this drug, did you also find that it kicked in very quickly?


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## Porterdog (Sep 17, 2010)

Agomelatine is one of those drugs that you only notice was working after you've been off it along time
Even so, it only worked about 20%


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## shy-one (May 10, 2008)

Porterdog said:


> Agomelatine is one of those drugs that you only notice was working after you've been off it along time


So in other words like nardil? Many people on nardil think they are "cured" or its "no longer working", but they really just forget how worse they used to feel before they were on it. I had the same thing happen to me.


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## Porterdog (Sep 17, 2010)

shy-one said:


> So in other words like nardil? Many people on nardil think they are "cured" or its "no longer working", but they really just forget how worse they used to feel before they were on it. I had the same thing happen to me.


Sorry i worded that wrong. As in you go off of it because you think it is doing nothing for you, but awhile after that you realise you did feel somewhat different during the time you where on it.
Comparing it to nardil is like comparing caffeine to speed, its only worthwhile as an augmentation drug imo.

Besides that, it only has a 2 hour halflife, so you'd have to take it every 4 hours or so to get a proper antidepressant effect. And all the stories i've read of people doing that has shown bad irritability and mood swings. That is unless you are taking it for sleep, the melatonin agonism would help you reset your sleep pattern i guess.


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## shy-one (May 10, 2008)

Porterdog said:


> Sorry i worded that wrong. As in you go off of it because you think it is doing nothing for you, but awhile after that you realise you did feel somewhat different during the time you where on it.
> Comparing it to nardil is like comparing caffeine to speed, its only worthwhile as an augmentation drug imo.
> 
> Besides that, it only has a 2 hour halflife, so you'd have to take it every 4 hours or so to get a proper antidepressant effect. And all the stories i've read of people doing that has shown bad irritability and mood swings. That is unless you are taking it for sleep, the melatonin agonism would help you reset your sleep pattern i guess.


While nardil definitely is more powerful, valdoxan still seems to be pretty decent (so far), and a hell of a lot better than any SSRI. I think I will use it as my "in between" med when I take a break from nardil to try and lose the weight I put on.

Yes it has has a short half life, but I believe this is when it increases dopamine, which I guess lasts throughout the next day? There is no doubt my anxiety/depression has been better over the past two days, but i'm still not 100% sure if its due to the valdoxan. I still need to give it more time before I can make an accurate judgement.

I also feel more motivated, which would indicate that it is probably due to an increase of dopamine. Again, still not as motivated as I felt on nardil (nardil made me move to a foreign country on the other side of the world!), but at least I can actually get out of bed in the morning now.


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## Porterdog (Sep 17, 2010)

shy-one said:


> While nardil definitely is more powerful, valdoxan still seems to be pretty decent (so far), and a hell of a lot better than any SSRI. I think I will use it as my "in between" med when I take a break from nardil to try and lose the weight I put on.
> 
> Yes it has has a short half life, but I believe this is when it increases dopamine, which I guess lasts throughout the next day? There is no doubt my anxiety/depression has been better over the past two days, but i'm still not 100% sure if its due to the valdoxan. I still need to give it more time before I can make an accurate judgement.
> 
> I also feel more motivated, which would indicate that it is probably due to an increase of dopamine. Again, still not as motivated as I felt on nardil (nardil made me move to a foreign country on the other side of the world!), but at least I can actually get out of bed in the morning now.


Sounds good, all i know is that its not a good drug to take on its own because of its lack of efficacy. It definately has a better side effect profile than SSRI's.

It supposedly increases dopamine and noradrenaline by attaching to the 5ht2c receptor, thus disallowing serotonin to attach. The 5ht2c receptor is responsible for inhibiting dopamine and noradrenaline release in certain areas of the brain. So when serotonin cant attach, dopamine and noradrenaline are disinhibited. However once the valdoxan is out of your system, its no longer attached, and my guess is your brain would release more serotonin to counter the effect, leading to less dopamine and noradrenaline in waking hours.

Sorry if that sounds retarded, im a bit drunk :drunk


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## shy-one (May 10, 2008)

Well after two good days I crashed yesterday and felt pretty depressed again... not sure whats going on. If I have no more improvement by the end of the week then its back to nardil...


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## gilmourr (Nov 17, 2011)

shy-one said:


> While nardil definitely is more powerful, valdoxan still seems to be pretty decent (so far), and a hell of a lot better than any SSRI. I think I will use it as my "in between" med when I take a break from nardil to try and lose the weight I put on.
> 
> Yes it has has a short half life, but I believe this is when it increases dopamine, which I guess lasts throughout the next day? There is no doubt my anxiety/depression has been better over the past two days, but i'm still not 100% sure if its due to the valdoxan. I still need to give it more time before I can make an accurate judgement.
> 
> I also feel more motivated, which would indicate that it is probably due to an increase of dopamine. Again, still not as motivated as I felt on nardil (nardil made me move to a foreign country on the other side of the world!), but at least I can actually get out of bed in the morning now.


Sounds like just fluctuations until week 8 or so when you'll have an idea of the real efficacy of valdoxan. I don't think either nardil or valdoxan are especially potent on dopamine release, but Nardil definitely should be stronger, so yeah makes sense.

I think you'll be back on the Nardil train though, lol. It's treating me well so far.

It definitely works on anxiety better for me than it does on depression. Zoloft beats nardil but it creates obscene amounts of apathy and disinterest.

What were your side effects again that made you stop it? Insomnia/weight gain I think if I remember correctly...


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## shy-one (May 10, 2008)

gilmourr said:


> Sounds like just fluctuations until week 8 or so when you'll have an idea of the real efficacy of valdoxan. I don't think either nardil or valdoxan are especially potent on dopamine release, but Nardil definitely should be stronger, so yeah makes sense.
> 
> I think you'll be back on the Nardil train though, lol. It's treating me well so far.
> 
> ...


I went off nardil due to weight gain and insomnia.

**** it, I can't take this pain any longer, going to start on nardil again tomorrow.


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## Porterdog (Sep 17, 2010)

shy-one said:


> I went off nardil due to weight gain and insomnia.
> 
> **** it, I can't take this pain any longer, going to start on nardil again tomorrow.


Have you considered trying parnate?
It would get rid of the weight gain at least. You would probably have worse insomnia though.


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## socialpiranha (Dec 9, 2012)

i wish there was a selective 5ht2c antagonist without the melatonin effects i think they just cause unwanted effects to be honest. 5ht2c not only has effects on nor and dop but oxytocin release as well. i have a theory that social fear/paranoia is dysregulation of oxytocin/vasopressin oxytocin release creates feelings of trust and love while vasopressin release creates feelings of distrust and terror. agonizing 5ht1a and antagonizing 5ht2c both increase oxytocin release i'd like to see something in the pipeline which potently and selectively agonize and antagonize these receptors respectively.

edit: Anyone ever combined buspirone and agomelatine? i know buspirone also has other effects and is only a partial agonist at 5ht1a but it would be interesting to know if these two meds synergize well. i dunno maybe they are contraindicated though.


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## Student00 (May 14, 2013)

*Gathering Research.*

Hello, 

I am currently conducting some psychology-related research into antidepressant drugs and side-effects. I have a survey which is running at the moment and I would be particularly interested in capturing some sample data from individuals who are using/have used Agomelatine. 
Please, if you could take a moment to complete the survey I would be very grateful.
Thank you,
Best,
Nick.


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## Student00 (May 14, 2013)

Student00 said:


> Hello,
> 
> I am currently conducting some psychology-related research into antidepressant drugs and side-effects. I have a survey which is running at the moment and I would be particularly interested in capturing some sample data from individuals who are using/have used Agomelatine.
> Please, if you could take a moment to complete the survey I would be very grateful.
> ...


Here is the Link: https://www.surveymonkey.com/s/3933B5L


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