Posted by polarbear206 on October 24, 2010, at 11:07:46
In reply to Ultra Rapid Cycling Stopped Using Valdoxan » alchemy, posted by Ron Hill on October 23, 2010, at 12:01:36
> alchemy,
>
> I have very good news. I think we can stop your ultra rapid cycling. The med is Valdoxan (agomelatine). Are you famillar with it?
>
> It is an antagonist of 5-HT2c, causing a release of DA and NE in the prefrontal cortex. Further, it is an agonist of M1 and M2.
>
> The med provides a mild antidepressant effect due the DA and NE release, and it stops rapid cycling by synchronizing the circadian rhythm of the patient, via the agonizing M1 and M2.
>
> Do you live in the U.S.?
>
> Novartis does not plan to submit their application for agomelatine to the U.S. FDA until 2012. However, Valdoxan is readily available on-line. The FDA allows patients to order up to three months worth of a medication from outside the U.S. In other words, you order 3 months worth, take the meds for 3 months, buy another 3 months worth, and on and on.
>
> For a relatively new med (2009), it is very inexpensive. Only eighty five dollars per 28 count of 25 mg tabs; plus shipping costs. However, insurance companies will not pay for meds that are not U.S. FDA approved. So, ya gotta pay the full price of the med. I don't understand the reason for 28 counts per box instead of 30 or 31.
>
> May I take a couple minutes to tell you how I started ultra rapid cycling? Was that a yes? I'll assume so.
>
> My very first p-doc was inept. Without any screening tests, he misdiagnosed me as ADHD instead of bipolar II. Further, he wrote scripts for Ritalin and Paxil, two of the worst meds that can be given to a bipolar patient. Especially if there are not fully ramped up moodstabilizers on-board first.
>
> Long story short, he pushed me into a full blown mania, and turned me into an ultra rapid cycler. I lost my engineering job, and as it turns out, I've got such a huge hole in my resume that I suspect I've lost my engineering career.
>
> All of this happened in 1996, so for the past 14 years I had been ultra rapid cycling; 6 days of debilitating depression followed by 9 days of normal mood. This repeated without stop for the 14 years.
>
> I track my moods by recording the level of depression each day. I enter these data into an Excel spreadsheet and Excel graphs these data. The graph was incredibly consistent, six days of depression, followed by nine days of normal. I wish I could somehow post a pic of the graph. I could accurately predict the day that I would cycle into depression. The severity of my depressive episodes varied, but the timing of the episodes was very consistent.
>
> I have been on 25 mg of Valdoxan for three months and I have never rapid cycled during the three months. Start-up side effects lasted 5 days and consisted of nightmares and choppy sleep. Every since my start-up side effects ended, my sleep has been excellent.
>
> Two problems that lingered, was amotivation and anergy. I fixed the problem by adding 2.5 mg/day of Adderall XR. It works GREAT!
>
> I AM SOOOOO HAPPY TO BE WELL. And, I think Valdoxan is worth you conducting a trial.
>
> Okay, let's talk about you.
>
> You're bipolar II, correct?
>
> If so, I'm very concerned about you having an SSRI on-board. Have you ever tried Parnate as your antidepressant? MAOIs work best on atypical depression.
>
> Do you have the atypical type of depression? Do you answer yes to five or more of these questions?
>
> Do you crave sweets or other carbohydrates?
> Do you tend to gain weight?
> Are you tired for no obvious reason?
> Do your arms or legs feel heavy?
> Do you tend to feel sleepy or groggy much of the time?
> Are your feelings easily hurt by the rejection of others?
> Did your depression begin before the age of 30?
>
> Wow, 400 mg/day of lamotrigine! Does it cause cognitive issues?
>
> Are you really attached to your benzo?
>
> Do you take any vitamins and supplements?
>
> Above and beyond and in addition to your lamotrigine, when you get hypomanic do you ever question if you would benefit by adding another moodstabilizer that has more antimanic efficacy?
>
> Alchemy, I'll have more questions, after you reply to this post.
>
> Here is the link to the Valdoxan Prescribing Information document:
>
> http://www.valdoxan.com/index.php/summary-of-product-characteristics/#
>
> Also, this one is even more in depth:
>
> http://www.valdoxan.co.uk/landing.aspx?redirect=/frequently-asked-questions-about-Valdoxan.aspx
>
> Take a look at the list below of my meds, vitamins, and supplements
>
>
> -- Ron
>
>
> Ron Hills dx and tx:
>
> dx: Bipolar II and mild OCPD
>
> 600 mg/day Trileptal (oxcarbazepine)
> 200 mg/day Lamictal (lamotrigine)
> 500 mg/day Keppra (levetiracetam)
> 90 mg/day Nardil (phenelzine)
> 25 mg/day Valdoxan (agomelatine)
> 2.5 mg/day Adderal XR (soon to be 2.5 mg/day Dexedrine Spansule)
>
> 3.75 mg/day Deplin
> 2500 mcg/day of sublingual methyl B-12
> 12.5mg/day of sublingual P-5-P
>
> 45 ml/day of Carlsons Bottled Fish Oil
> 200 mg/day phosphatidylserene
> Multi-vitamin/day; Only 100% of all the usual vitamins; NO VANADIUM!!
> 2000 IU/day Vitamin D-3
> 850 mg/day of Mg 212% of RDA (as 5 grams of Mg Malate)
> 200 mcg/day GTF Chromium
> 600 mcg/day Cromium Picolinate
> 200 mg/day Co-Q10
> 1000 mg/day Cinnamon
> 480 mg/day Milk Thistle
> 2 g Vitamin C
>
> Whats next to add?:
> NAC, + 8 to 10 glasses of water, + Acetyl-L-Carnitine, + Alpha-Lipoic Acid, + Vitamin C
> Dark therapy via LowBlueLight glasses
>
>
>Hi Ron, So glad your doing well. I've been very interested in Valdoxan and plan to trial it when it hits the market in the states. I meet all of the criteria, except rejection sensitivity. Prior to Lamictal, these symptoms were worse in the winter months. Still there, but not as pronounced. My main problem is periods of foggyness, concentration problems, and some residual fatigue. Motivation in the morning is a problem too at times. Currently taking effexor 300mg and Lamictal 200mg. I'm going to try and cut back on the effexor very slowly and add a low dose of Focolin. P-doc wants me to try this first vrs Provigal. Anyone have experiences with Focolin? Also Ron, have you ever tried to add Inositol to your mix? 12-18 gms/day from info I have gathered. Plan to trial this at some point.
Depression dominated mild bipolar.
poster:polarbear206
thread:966574
URL: http://www.dr-bob.org/babble/20101020/msgs/966799.html