Posted by Bob on December 4, 2010, at 1:09:02
In reply to Re: Valdoxan availability » Bob, posted by Ron Hill on December 2, 2010, at 2:11:35
> 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
>
>
RonMy diagnosis is essentially MDD, I have plenty of anxiety problems, irritability, and rumination obsession problems as well. This can all be blunted with SSRIs, but then the will to do anything or get joy out of anything is all but gone.
My hope with the Valdoxan would be to help my severely shifted circadian cycle. The longer I'm exposed to SSRIs the harder it is to get up in the morning and the harder it is to sleep at night. Eventually I find myself getting up in the early afternoon and staying up until 2 or 3 in the morning. I have been able to do little to nothing to change this over the 20 years I've been dealing with psych drugs. I also have problems with fatigue and drowsiness during the day as well.
Bob
poster:Bob
thread:970772
URL: http://www.dr-bob.org/babble/20101203/msgs/972377.html