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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Franz on March 4, 2011, at 10:21:36
Hello, Doc suggested switching from escitalopram 10 mg to agomelatine.
It is very expensive so I have to evaluate it.
As I understand it enhances melatonin "reception" or sensitivity. When I used melatonin to sleep I had nightmares. Will this happen with agomelatine?
The supposed (I read articles negating this) 5-HT2C receptor antagonism affects serotonin?. How does this compare to escitalopram. Can this also have an anti obsessive effect?
Is the structure of agomelatine similar to tianeptine?
Thanks and sorry for all the quesations.
Posted by desolationrower on March 25, 2011, at 6:29:46
In reply to Please explain agomelatine action on 5HT?, posted by Franz on March 4, 2011, at 10:21:36
> Hello, Doc suggested switching from escitalopram 10 mg to agomelatine.
>
> It is very expensive so I have to evaluate it.agomelatine seems to be bit faster working than some other drugs. the best way to know is spend a week or three with it.
> As I understand it enhances melatonin "reception" or sensitivity. When I used melatonin to sleep I had nightmares. Will this happen with agomelatine?
maybe, maybe not. the 5ht2c antagonism should decrease time spent in REM so there should be less 'dreaming' than with pure melatonin.
> The supposed (I read articles negating this) 5-HT2C receptor antagonism affects serotonin?. How does this compare to escitalopram. Can this also have an anti obsessive effect?serotonin=5ht. ssris are blunt, whereas blocking a certain receptor is a more specific effect. this can be good or bad; it can avoid side effects, or not do the useful thing you need. I think there is some evidence on 5ht2c in OCD though most looks at 5ht2a.
> Is the structure of agomelatine similar to tianeptine?
>probably just to the extent that is needed to be sorta kind like 5ht and so effect various things 5ht intereacts with.
> Thanks and sorry for all the quesations.
>
>-d/r
Posted by Franz on March 25, 2011, at 13:37:42
In reply to Re: Please explain agomelatine action on 5HT?, posted by desolationrower on March 25, 2011, at 6:29:46
> > Hello, Doc suggested switching from escitalopram 10 mg to agomelatine.
> >
> > It is very expensive so I have to evaluate it.
>
> agomelatine seems to be bit faster working than some other drugs. the best way to know is spend a week or three with it.
I took it for 11 days.
>
> > As I understand it enhances melatonin "reception" or sensitivity. When I used melatonin to sleep I had nightmares. Will this happen with agomelatine?
>
> maybe, maybe not. the 5ht2c antagonism should decrease time spent in REM so there should be less 'dreaming' than with pure melatonin.Unfortunately not. I experience shortened sleep (4, 2, 5 hours) and frequent nightmares.
The good part is that it is easier to fall asleep.
>
> > The supposed (I read articles negating this) 5-HT2C receptor antagonism affects serotonin?. How does this compare to escitalopram. Can this also have an anti obsessive effect?
>
> serotonin=5ht. ssris are blunt, whereas blocking a certain receptor is a more specific effect. this can be good or bad; it can avoid side effects, or not do the useful thing you need. I think there is some evidence on 5ht2c in OCD though most looks at 5ht2a.
>It seems that escitalopram is better for ruminarions.
Thanks.
Posted by sigismund on March 29, 2011, at 13:00:58
In reply to Re: Please explain agomelatine action on 5HT?, posted by desolationrower on March 25, 2011, at 6:29:46
> Is the structure of agomelatine similar to tianeptine?
The effect of agomelatine is not dissimilar to that of tianeptine.
Posted by Franz on March 29, 2011, at 14:03:53
In reply to Re: Please explain agomelatine action on 5HT?, posted by sigismund on March 29, 2011, at 13:00:58
> > Is the structure of agomelatine similar to tianeptine?
>
> The effect of agomelatine is not dissimilar to that of tianeptine.Really?. I tried both and feel quite different, almost opposite.
Posted by sigismund on March 31, 2011, at 13:55:36
In reply to Re: Please explain agomelatine action on 5HT? » sigismund, posted by Franz on March 29, 2011, at 14:03:53
They both feel dopaminergic though, don't you think?
Posted by mtdewcmu on April 14, 2011, at 0:39:22
In reply to Please explain agomelatine action on 5HT?, posted by Franz on March 4, 2011, at 10:21:36
> Is the structure of agomelatine similar to tianeptine?
The chemical structures look nothing alike. Tianeptine has the basic tricyclic structure, and agomelatine looks like phenethylamine with so many substitutions that it's hard to recognize.
This is the end of the thread.
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