Medical research - future medication

[gcl86]

Really great read there sir! Like yourself phsyopoet my side effects were hellish for want of a better word and put me in a worse state than when i started off and to see that there could be meds that ease that and in a quicker time,wow!!
Can only get better med wise for future sufferers.

[NoPoet]

I have made minor edits to the agomelatine post on page 1 of this thread.

BexieB, I cannot advise you to switch to agomelatine as I'm not a doctor and I do not know anyone who's ever taken it, and because it's so new we don't know what the long term implications might be, but to be honest if I were you I would be tempted to switch.

I've got a review with my doctor next week and I intend to mention it.

I am estimating that we will have some very effective depression treatments in about 10-20 years. I can't honestly see it taking longer than that as the world appears to be facing a crisis of mental health issues and something needs to be done to prevent it from getting out of control. This is a problem that faces every country in the world.

[gxyslcuq]

"NHS Scotland has declined to use agomelatine as the manufacturer was unable to provide sufficient financial data about the medication. This is purely about money and does not reflect any concern about the medication's effectiveness at treating depression."

That's wrong, I'm from Scotland and have been on Agomelatine for just over a week now.

[KK77]

AGOMELATINE


Agomelatine Update (2/12/09):

Spanish medical researchers have declared agomelatine to be superior to sertraline for treating severe depression. Agomelatine works more quickly and the researchers found that its beneficial effects on sleep meant the agomelatine began to work faster than sertraline.

After 6 weeks of treatment, agomelatine was clearly superior at reducing anxiety and depression. In every study there are people who discontinue treatment due to side effects. Fewer people gave up on the agomelatine than gave up on sertraline, which indicates that agomelatine either has fewer side effects than established medication, or the side effects that do occur are less severe.

Once again, it was noted in this study that agomelatine did not cause daytime droswiness.

The Spanish researchers concluded that agomelatine appears "promising" in the fight against major depression.

Finally, British research appears to indicate that agomelatine users may not be as prone to relapse as people who discontinue use of other types of antidepressant medication. It is also thought that agomelatine could be useful against major depression that has resisted other medical treatments. However, there is not currently enough evidence to confirm either of these two points, and the British researchers advise caution when using agomelatine, as there are many better-understood medications available which do have a positive impact against major depressive disorder.

It is not likely that doctors will begin wide-scale prescription of this medication in the UK until more is known.

NHS Scotland has declined to use agomelatine as the manufacturer was unable to provide sufficient financial data about the medication. This is purely about money and does not reflect any concern about the medication's effectiveness at treating depression.

Well, I nearly fell off my chair when I saw that the Spanish study you refer to was funded by Servier - the manufacturer of agomelatine! Who would have predicted that?... Other studies have found that agomelatine is of only "comparable" efficacy to paroxetine and sertraline, so I really wouldn't believe all the Big Pharma bull here.

I personally wouldn't take such a new drug. The long-term effects of playing around with melatonin and other neurotransmitters are unknown. And if it works as well as is claimed, what happened to the serotonin theory of depression? Eg, bupropion (Wellbutrin) acts on noradrenaline and dopamine and doesn't touch serotonin re-uptake yet it's as effective as SSRIs. Depression is obviously not as 2-dimensional and textbook-medicine-based as the experts think. But carry on with your research... It's very interesting.

[NoPoet]

Thanks for the input everyone... remember that I am compiling this from research done on the internet, and I have to go with the most commonly available data. The most common data I can find indicates that agomelatine has generally superior effects to SSRIs, but I also acknowledge that no-one has enough experience with agomelatine.

Remember that all of the drugs and therapies in this thread are either experimental, theoretical or newly released, so we do not have 100% of the story.

Other studies have found that agomelatine is of only "comparable" efficacy to paroxetine and sertraline, so I really wouldn't believe all the Big Pharma bull here.

I have just read my first study today which showed that over 6 trials, in 3 of them agomelatine failed to outperform placebo, but in the other 3 it significantly outperformed placebo and also beat fluoexetine. The same study confirmed that agomelatine does not appear to cause withdrawal symptoms even when a high dose is discontinued. Most of the information I have read (which were actual medical reports not sponsored by the manufacturer) indicate that agomelatine *may* be a step in the right direction.

That's wrong, I'm from Scotland and have been on Agomelatine for just over a week now.

I will amend the part where it says NHS Scotland won't use agomelatine but that was the most up to date information I found. Obviously they have decided to change their policy. If you coould make a detailed post about the effects and usefulness of your agomelatine treatment, I would be very interested.

And if it works as well as is claimed, what happened to the serotonin theory of depression? Eg, bupropion (Wellbutrin) acts on noradrenaline and dopamine and doesn't touch serotonin re-uptake yet it's as effective as SSRIs.

I also believe there are a wide variety of causes of depression which would explain why serotonin reuptake inhibitors don't always work. I believe in some people, targeting serotonin reuptake is what is needed to fix it, but medical research is getting broader and I think we will get closer to a "cure-all" treatment, or if that is not possible we will eventually develop specifically targeted treatments for each type of depression. Agomelatine seems to represent a step in this direction, an evolution of current thinking. If medical science is ever going to cure depression it needs to think outside the box.

[NoPoet]

Agomelatine section has received a significant update. If anyone can give me more information about agomelatine, I will start a separate thread about it.

[NoPoet]

Deep Brain Stimulation (DBS)

High-tech alternative to brain surgery, under investigation as a treatment for major depression, treatment-resistant obsessive compulsive disorder and schizophrenia.

In years gone by, psychosurgery was employed as a final line of defence against severe mental illness. This involved cutting a "lesion" into a specific area of the brain to try to reduce the symptoms of mental illness and/or depression. While in some cases this technique can be used today, psychosurgery is generally regarded as unnecessary, risky and even barbaric in the age of modern medicine.

Deep brain stimulation is a form of psychosurgery which can probably be regarded as less extreme, less risky and less "barbaric".

An electronic device called a "brain pacemaker" is inserted into a specific region of the brain. The region targeted depends on what exactly the pacemaker is trying to treat. Electrical pulses are sent from the brain pacemaker into the brain. These interfere with the activity in that region of the brain. In the case of a depressed person, this interference can provide substantial relief from the symptoms of depression.

There are indications that DBS may be effective against schizophrenia and research is ongoing.

At this point in time DBS is not considered a viable treatment for depression, OCD and schnizophrenia. Trials have not been extensive, the surgery carries some risks (see below) and there is disagreement about how DBS actually relieves the symptoms of depression etc.

However, research continues, and there have been some encouraging results which indicate that DBS may come into its own in the future as our technology and scientific understanding improves.

Side effects

The side effects are potentially life-changing and can be severe. The surgery itself may present serious complications, although I do not know whether or not these complications are common.

If the brain pacemaker is not inserted correctly, or the brain "shifts" during surgery (which is common but not serious provided the "shift" is noticed by the surgeons and the pacemaker is still inserted properly), all kinds of havoc might result. The effects of an improperly sited brain pacemaker can be personality changes and severe depression, although it is believed that these problems will be resolved as soon as the pacemaker is either removed or placed in the proper location.

In a small number of test cases, side effects of the DBS were symptoms of psychosis and even one failed suicide attempt.

Hallucinations, obsessive gambling, obsessive sexuality and depression were also noted as side effects following successful activation of brain pacemakers. Again, these side effects may be reversible following removal or relocation of the brain pacemaker.

[Bill]

Interesting!

So like most ad's, this new one is supposed to be very effective for severe depression because it will lift the sufferers mood.

Finally, agomelatine appears to be useful against anxiety as well as depression, although one of the side effects may be temporarily heightened anxiety.

So in other words, it's also supposed to be effective in easing the "anxious symptoms" that our underlying anxieties, fears and daily stresses cause but you could feel even feel more anxious at first before the original "symptoms" settle.

Well, at least hopefully when we panic in shops because we feel too stressed at work or at home, the panics hopefully won't feel so frightening because we'll be feeling "happier" in our mood.

[NoPoet]

Hi Bill, yes the agomelatine can increase anxiety at first like most antidepressant meds, but in the long run it seems to be useful at reducing anxiety overall. Agomelatine seems to increase its effectiveness the more severe a user's depression is. So if a person is suffering very badly with depression and/or their depression has not responded well to previous treatments, agomelatine seems to offer new hope.

I notice when I'm having a good day, eg anxiety and/or low mood are not present or do not interfere with my life, then I respond to stress, unhappiness and anxiety-causing situations in a more positive, assertive and constructive manner. This is what antidepressant meds are supposed to do for us full time.

[NoPoet]

Well I've not had chance to do more research and there are no new developments regarding agomelatine yet - I just cannot find anyone who has been on it for more than a few days, which is not long enough to fully assess the medication's effects. This is an appeal for help, please let me know if you have taken agomelatine or you know someone who has.

In better news, the idea of agomelatine seems to be catching on, and its melatonin effects are slowly proving their worth against bipolar disorder and insomnia.

I still think the melatonin approach seems to be a good avenue for research. After all we've been developing serotonin medication for 50 years and we are still nowhere near developing a decent drug.