Agomelatine, sold under the brand names Valdoxan and Thymanax, among others, is an atypical antidepressant most commonly used to treat major depressive disorder. Dr Syl tells you what you need to know
Hey guys dr still here junior doctor from sydney australia so you or someone you know has been prescribed valdoxan or ago melaton this video is a bit of an overview where i tell you everything i think you need to know let’s get started ago melaton presents a novel way of treating depression and anxiety disorders through kind of re-synchronizing rebalancing the
Circadian rhythm of people who suffer from the illness does this by binding to the melatonin one and two receptors and inhibiting the serotonin 2c the 5-ht2c receptors this kind of unique profile of mechanism of action means that it has its own unique way of treating um uh you know depression and anxiety it’s it’s off label for anxiety it’s more for depression
But people have found it to be beneficial in both which means that if one of the other medications didn’t work for you or someone you know then maybe this one will how long does it take to work well you know antidepressants always take at least a month but you should find some effect on your sleep within the first week of use you should find that you you sleep
Better or fall asleep better within one week of regular use but after a month you should see some kind of effects especially on better sleep more daytime alertness and better mood yeah usually after months but and that could be sustained for years in some trials but what seems to happen is that it’s not a cure so if people stop the medication they’re at risk of
Redeveloping symptoms again now this is you know this is mental health there is no medication that works for everyone with 100 efficiency or efficacy so this might not work for you if it doesn’t you might need a dose change and you might just be treatment resistant you need to work with your healthcare provider to either change or increase the dose there are options
To augment this with another pharmacotherapy another drug and and that has to be done in consultation with your doctor but i think the key thing just to also remember is that you can’t treat mental illness with drugs alone you know drugs give you a good pair of shoes but you’d still need to walk up the mountain and that walking is psychotherapy so it’s always
Drugs plus psychotherapy in my book so um you should be combining this with you know meetings with a psychologist to do you know cbt or whatever you need whatever the psychologists thinks is indicated to to address your symptoms a big thing to look out for whenever starting any kind of depression or anxiety anxiety management or medication is is symptoms of mania
And suicidal ideation and and becoming activated what i mean by that is becoming anxious alert neurotic irritated um you know you know really aroused because if it could you know some of these medications can trigger manic states in people who have bipolar disorder but haven’t been diagnosed so some people you know have looked like they’ve had depression their whole
Life but really it’s a bipolar disorder which is a different illness that looks like depression but they just haven’t had their first manic episode or their first manic episode wasn’t captured in in the history or something so um and you don’t want to have another manic episodes manic episodes are bad so you don’t want to trigger that with the medications and it’s
Possible that um you know medications like this can trigger a manic episode in people who are incorrectly diagnosed or not yet diagnosed with the correct illness so that’s just something to be very aware of that if you find your you know yourself going down what looks like a manic episode you need to talk to your doctor you know the same day now edgar melton very
Effective medicine but it is metabolized in the liver with that sip enzyme system the 1a2 the sip 18 2 enzyme which means a couple things first of all since it’s metabolized in the liver there are very small number of people who have who have had hepatitis develop so an inflammation of the liver and and so you do need regular liver function tests as blood tests
And you can do that with your primary care provider like your gp or your family physician the other thing is if you’re taking other medicines that are metabolized by the same enzyme it can affect the concentration of one or both of them the medications so you need to work with your doctor to make sure that you don’t have any other medications that could interact
With this medicine now this liver stuff is very rare much more commonly you can get nausea diarrhea dizziness and these side effects are minor and will and usually passed with time and remember just because you’re getting mild side effects from medication doesn’t mean you need to stop straight away if they’re mild because you have to compare the side effects of
The medication to the side effects of not taking the medication and so if it’s a bit of diarrhea that lasts three or four days and ends resolving don’t just stop the medication talk to your doctor about what to do if that happens and maybe the best decision is to continue because it’ll get better if though the side effects are intolerable then you might just have
To change antidepressant and i i guess i say that in a blase way and i’m sorry about that i guess it is a pain to change antidepressants because they take so long to have an effect and luckily with edgar melton you can just stop it you don’t need to taper it down some other medicines you do need to taper down so always double check all this with your doctor this
Is not medical advice you should not be going to youtube for medical advice if you need medical advice go see your doctor i guess the biggest take-home point here is that this is the medicine that acts on the melatonin system which means you want to take it at night melatonin is the hormone that is released to that makes you feel sleepy when um when there is no
Blue light and it’s released by a pioneer and and so when you know at the end of the day the sun goes down and and it’s in you’re in darkness you know not anymore but evolutionarily speaking uh these days you’re on your phone which you shouldn’t be but whatever uh yeah evolutionaries speaking when the sun goes down it’s dark then that that triggers your eyes which
Triggers your pineal gland to release um melatonin which makes you feel sleepy and yeah so i think the best and the final point to make is that there’s very little um sexual side effects and symptoms with ego melaton so um which is fantastic because a lot of people struggle with uh some of the other classes like the serotonin reuptake inhibitors um often can have
Some kind of sexual side effects so if you’ve uh tried one of them you should talk to a doctor i mean if you’ve tried an ssri and then and you’ve had sexual side effects or other intolerable side effects this is a good other option to talk to your doctor about um but you know this is medical advice talk to your doctor i’m just a junior doctor uh you know so so do
Your due diligence uh this is just to give you a bit more context around some of the medications that you may have been prescribed and that is it for this video i have an absolutely lovely day guys i’ll see you in the next one bye for now if you like this video please subscribe by the way that helps the channel grow bye
Transcribed from video
If you're taking VALDOXAN (Agomelatine) – WATCH THIS. By Dr Syl