Posted by Ron Hill on December 2, 2010, at 2:11:35
In reply to Re: Valdoxan availability, posted by Bob on December 1, 2010, at 20:47:19
Bob,
> I am currently taking 125mg sertraline, 70mg nortriptyline, and about .250mg Klonopin each night.
Your p-doc might have a concern that Valdoxan (agomelatine) releases DA and NE in the frontal cortex due to the agonist action at 5-HT2c. Therefore, Valdoxan will add to the NE effects of nortriptyline.
However, Scott (SLS) took 25 mg/day of Valdoxan while taking Nardil and nortriptyline without any negative interactions. Further, I take Valdoxan with 90 mg/day of Nardil without any hint of a hypertensive crisis.
Valdoxan is metabolized mainly by cytochrome P450 1A2 (CYP1A2) (90%) and by CPY2C9/19 (10%). See the Valdoxan Prescribing Information document:
http://www.servier.co.uk/pdfs/Valdoxan_PI.pdf
Zoloft (sertraline) is metabolized by cytochrome P450 2D6. See page 23 of the Zoloft Prescribing Information document:
http://media.pfizer.com/files/products/uspi_zoloft.pdf#page=43
Pamelor (nortriptyline) is metabolized by cytochrome P450 2D6. See page 6 of the Pamelor Prescribing Information document:
http://www.psych.uic.edu/csp/Physicians/Patient%20package%20inserts/Pamelor.pdf
Klonopin is metabolized by cytochrome P450 3A. See page 8 of the Klonopin Prescribing Information document:
http://www.gene.com/gene/products/information/klonopin/pdf/pi.pdf
Therefore, there aren't any metabolism interactions between Valdoxan and the other meds that you are currently taking.
As an aside, please note that there is a metabolism interaction between Zoloft and nortriptyline. Therefore, there is an increase in the plasma concentrations of both Zoloft and nortriptyline in your body, above which would be expected for the dosages of the two meds.
Bob, if you don't mind my asking, what is your dx; OCD, PTSD, anxiety disorder, or ??
What do you hope to accomplish by adding Valdoxan; better sleep?
-- Ron
poster:Ron Hill
thread:970772
URL: http://www.dr-bob.org/babble/20101117/msgs/972152.html