@The450Man 717 wrote:

Surely no one has much if any experience with this drug. Many have never even heard of it. Its quite unique. Thoughts? Opinions?

http://www.valdoxan.com/

http://en.wikipedia.org/wiki/Agomelatine

I wana get my hands on some of this stuff.

Apparently, it has been approved in Europe, but is still in phase III trials in the U.S.

This means it still has a long way to go to prove that it works as an antidepressant.

This is an interesting medication.

It has a very short half-life – about 1-2 hours.

It blocks Serotonin 2C receptors and it triggers Melatonin MT1 and MT2 receptors.

Blocking Serotonin 2C receptors apparently may increase frontal cortex dopamine and norepinephrine, accounting for its antidepressant effects.

Triggering Melatonin 2 receptors is an action similar to that of Melatonin, except Melatonin also triggers MT3 receptors. It is more similar to Rozerem in this regard – triggering MT1 and MT2 receptors. Thus perhaps it promotes sleep.

Blocking Serotonin 2C receptors, however, has problems. Serotonin 2C receptors are also famously blocked by the Atypical Antipsychotic medications – such as Olanzapine, Risperidone, Clozapine, etc.

Blocking Serotonin 2C receptors is associated with significant appetite increase and weight gain.

Serotonin 2C receptors are also associated with diabetes. Triggering Serotonin 2C receptors helps reduce insulin resistance and reduces the severity of diabetes. Blocking them would be expected to have the opposite effect.

Also, in depression and stress and suicide, Serotonin 2C receptor are produced in a defective, less effective receptor state – compared to the non-depressed, non-stressed, non-suicidal individuals. Blocking Serotonin 2C receptors produces a similar effect.

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The listed side effects in short term use are:
(common means between 1 to 10% of patients, uncommon means between 0.1 to 1 %)

Nervous system disorders:
Common: headache, dizziness, somnolence, insomnia, migraine
Uncommon: paraesthesia

Eye disorders:
Uncommon: blurred vision

Gastrointestinal disorders:
Common: nausea, diarrhoea, constipation, upper abdominal pain

Skin and subcutaneous tissue disorders
Common: hyperhidrosis
Uncommon: eczema
Rare: erythematous rash

Musculoskeletal and connective tissue disorders
Common: back pain

General disorders and administration site conditions:
Common: fatigue

Hepato-biliary disorders:
Common increases (>3 times the upper limit of the normal range) in ALAT and/or ASAT (i.e. 1.1% on agomelatine 25/50 mg vs. 0.7 % on placebo).
Rare: hepatitis

Psychiatric disorders:
Common: anxiety
Frequency not known: Suicidal thoughts or behaviour

Side effects are fairly common with this medication.

Thus, I would wonder what effects on the rest of the nervous system, endocrine system, and immune system it is triggering. Some of these effects would negate any good effects from treatment.

I would not be so quick to jump on the bandwagon for this medication.

I would have preferred a medication that would block Serotonin 2A. That would be a more useful medication. I am still waiting for one.

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Note that in psychiatry, medications are chosen by a process similar to throwing mud on the wall then determining which one of the mud balls stick, through statistical analysis. Medications are generally not chosen because they actually treat the pathophysiology of the mental illness. They are chosen primarily because of statistical improvement versus placebo.

The primary reason this occurs is that there is no definition of “the mind” in all of medicine – including psychiatry and other mental health fields. Thus, the pathophysiology of a mental illness cannot be established. If one doesn’t know what one is looking it, one can’t determine what is wrong.

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Of course, this begs the question, what is my definition of the mind. That is something I will post in the near future. That is why I called my site “The Definitive Mind” in the first place.

Liver function tests should be performed in all patients: at baseline and periodically after about six weeks, twelve weeks and twenty-four weeks and then when indicated.Patients clinical depression should be treated for a sufficient period of at least six months to ensure they are free symptoms.Valdoxan, tablet 25 mg at bedtime, offers new hope for the 33 million people in Europe suffer from major depressive disorder.

Everybody should try a ketamine infussion. It really helps with moods, but more importantly a spiritual experince. Psychedelics are needed in today’s world to build peace, tolerance, and empathy.