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Marx: Tapering Valdoxan / Agomelatine


marx

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How are you doing, RipVanWinkle? I am currently having hard time with valdoxan withdrawal after being on it about 1 year, and stopped cold turkey. Previously I have stopped it without any withdrawal, so it was/is weird for me that it's there. So far the worst symptom I'm experiencing is blurred, hypersensitive vision, and it hasn't improved in a month.

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

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  • Moderator Emeritus

Hi Marx, welcome to SA. I have moved your post to create an introduction for you. All members must have an introduction before replying to other topics. 

 

Many people can quit a drug without any withdrawal effects, but later when they try to quit, maybe years later they suffer withdrawal. Things change all the time and what we tolerate one year we can react to the next, the more drugs we take, and the more time on them the harder it is to get off them.

You are suffering from withdrawal so you might be better to reinstate a small dose then when you are stable you can taper off that small dose. We ask all our members to create a signature, you can find instructions here... 

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

I found your post in the tapering valdoxen topic, so you probably read it but here is the link

http://survivingantidepressants.org/index.php?/topic/10456-tapering-valdoxan-agomelatine/

 

About reinstating to stabilise

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

You might find fish oil and magnesium helpful, many of us here take it regularly and it really helps with withdrawal symptoms. 

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/?view=findpost&p=100596&hl=magnesium

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Thank you! 

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

Link to post

So I went to get some valdoxan to try and reinstate it, but got nothing. I made a crucial mistake by telling her I stopped CT and feel really ill - she didn't want to give me these drugs, said maybe I should go to the crisis center (stay for 10 days, detox or something). Thought I was getting better but today feel even worse - extreme irritation, anger, brain fog, dizziness, nausea, I'm really scared I could faint, I'm not really sure what to do. Been reading all day and reassuring myself that it's just a withdrawal, though the physical symptoms are getting unbearable.

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

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  • 2 weeks later...
  • Moderator Emeritus

Hello Marx,

 

I've moved your post here as it is about your individual situation.  You can post all such questions here, so your info will stay together. 

 

Is it possible for you to go to a different doctor and say you believe you would do better on the drug?  Then, as MammaP says above, you could reinstate a very small amount (since it's been such a long time since your last dose).  You will need to be calm, and sure about what you are saying, before you go to the doctor. 

 

Remembering that symptoms come in windows and waves can also help:  the-windows-and-waves-pattern-of-stabilization

 

Karen

2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

My story of healing:ContinuedHealing

***I am not a doctor; please do your own research and be able to take responsibility for decisions you make.*** 

           'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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  • 2 weeks later...

Would reinstating to a different drug would act the same as reinstating to the original drug? I know sertraline works on different receptors, but still hits those that valdoxan did, so I think it'd work. Am I correct?

Edited by scallywag
merged topics

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

Link to post
  • Moderator Emeritus

marx I've moved your post/question to your introduction topic so that all your information, questions and answers are in one place.

 

Our experience is that each medication is different and affects each person differently.  People have withdrawal reactions when switching from one medication to another, even one that is considered similar or when one drugs is derived on the other: e.g switching from desvenlafaxine (Pristiq) to venlafaxine (Effexor), or from escitalopram (Lexapro) to citalopram (Celexa). 

 

Think of it this way: You created a lock and key when you started taking agomelatine. The lock is your receptors and agomelatineis the key and the best fit for that lock.  Reinstating another drug would be like taking a key for another lock and then working to adjust the lock so that the new key fits. Sounds easy but your brain is as quickly adjustable as a lockset.

 

Quick quote from drugs.com

Quote

The active substance in Valdoxen, agomelatine, is a ‘melatonergic agonist’ and a ‘5-HT2C antagonist’. This means that agomelatine stimulates the melatonin receptors MT1 and MT2 (these receptors are normally activated by a natural hormone, melatonin) and it blocks the 5-HT2C receptors (these receptors are normally activated by a chemical messenger, serotonin).

 

 

Quote

The mechanism of action of Sertraline is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin (5HT). Studies at clinically relevant doses in man have demonstrated that Sertraline blocks the uptake of serotonin into human platelets. In vitro studies in animals also suggest that Sertraline is a potent and selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. In vitro studies have shown that Sertraline has no significant affinity for adrenergic (alpha 1, alpha 2, beta), cholinergic, GABA, dopaminergic, histaminergic, serotonergic (5HT 1A, 5HT 1B, 5HT 2), or benzodiazepine receptors;

 

It is unlikely that introducing sertraline will address your symptoms in the way that, and as quickly as that reinstating agomelatine might.

 

Why are you asking about sertraline?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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I've got a prescription for it, but tried to refrain from taking it, thinking I may be able to reinstate to valdoxan.

 

17 hours ago, scallywag said:

It is unlikely that introducing sertraline will address your symptoms in the way that, and as quickly as that reinstating agomelatine might.

 

Why are you asking about sertraline?

 

Not at the moment, that's the point. Atm I can take sertraline, so I was thinking it might do the job. I guess I'll have to think of something else now, thank you both!

 

On 10/07/2017 at 7:26 AM, KarenB said:

Is it possible for you to go to a different doctor and say you believe you would do better on the drug?  Then, as MammaP says above, you could reinstate a very small amount (since it's been such a long time since your last dose).  You will need to be calm, and sure about what you are saying, before you go to the doctor. 

 

Remembering that symptoms come in windows and waves can also help:  the-windows-and-waves-pattern-of-stabilization

 

Karen

 

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

Link to post

A quick question - if I tried reinstating a small amount (2 days), and it didn't help - should I taper the dose or just drop it?

2016 ~may-june: 25mg valdoxan

2017 ~may: stopped cold turkey

currently going through withdrawal (blurry vision, sensitivity to light, bouts of nausea, headaches)

Link to post
  • Moderator Emeritus

marx - 2 days is too short a time period to evaluate whether a reinstatement is working.  A negative reaction will show up in that time frame, but improvements generally take longer. The drug takes 3-4 days to reach a steady state in your system and then it takes at least another 7-10 days for your CNS (central nervous system) to respond by easing symptoms.

 

Are you keeping notes of the times of your symptoms dose(s) on paper? This post has a useful format for a daily log:

Take notes of doses and symptoms.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to post
  • 9 months later...

Hey Marx!

 

How are you doing? Did you reinstate?

History:

Escitalopram 10mg Nov - Jan 2016 (switched to Effexor XR)

Effexor XR 37,5mg Jan - Feb 2016; 75mg Feb - April 2016; 37,5mg for one week in April, 75mg April-July 2016 (started tapering, took my last beads on Sept 11.)

The fluctuations happened because my GP mistakingly prescribed me the wrong dosage.

Oxazepam 2x10mg Dec 2015 - Jan 2016 (basically CT but no apparent symptoms); June 2016 - Feb 2017 (c/o to Valium)

 

Current:

Valdoxan 25mg Dec 2015 - Sept 2016. 12.4mg (Sept - Nov '16) -> 11.86mg (Nov '16) -> 10.75mg (Dec '16) -> 9.75mg (Jan '17) -> 8mg (March '17) -> 7mg (April '17) -> 4.5mg (May '17) -> 4mg (Jan '18) -> updosed to 4.5mg in the end of January

Valium (liquid form) 8.5mg Feb 2017. 7.6mg (June '17) -> 7.2mg (June '17) -> 6.8mg (July '17) -> 6.4 (Sept '17) -> 6.2 (March '18) -> 6 (April 7 '18) -> 5.8 (April 17 '18) -> 5.6 (April 26 '18) -> 5.4 (July 16 '18) -> 5.2 (March '20) -> 5 (March '20)

What to take away from all this: if you feel extremely sick only after a few doses of an AD, please tell your doctor and just stop. Adding medications is no bueno.

 

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  • 1 month later...

Hey Marx what are your symptoms now that you have cold turkey 

Gabapentin 600 valporate magnesium (depakote) 200. April 15 2017 to Aug 15 2017

Zoloft 50mg from April 15 2017to Aug 15 2017 

Valdoxan 25 mg  Oct 1 2017 to Feb 25 2018

I quit evrything cold turkeyturkey 

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Marx when did your symptoms peak ?

Gabapentin 600 valporate magnesium (depakote) 200. April 15 2017 to Aug 15 2017

Zoloft 50mg from April 15 2017to Aug 15 2017 

Valdoxan 25 mg  Oct 1 2017 to Feb 25 2018

I quit evrything cold turkeyturkey 

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