How it works
What does agomelatine do?
Agomelatine is an antidepressant used to treat depression.
The brain is usually good at making sure we have enough of the chemicals we need to function properly. But depression can affect a number of brain chemicals.
One such chemical is serotonin; depression reduces serotonin levels.
Another chemical depression affects is melatonin. Reduced melatonin is linked to disturbances in our sleep patterns.
Agomelatine is the first antidepressant to increase melatonin activity directly. It does this by acting like melatonin at the target sites where melatonin (these are known as the melatonin receptors).
Agomelatine also affects serotonin in two helpful ways.
By increasing melatonin activity, agomelatine also increases serotonin activity. If serotonin activity is increased at all target sites, this can cause a number of side effects, most of which are linked to one particular target site (5HT2c). However, the second helpful way agomelatine affects serotonin is by blocking serotonin from getting to this particular (5HT2c) target site.
How long does agomelatine take to start working?
It can take up to four weeks for agomelatine to have its full effect, but it should start to help within the first one to two weeks if you are taking it for depression.
Your doctor will probably start you on the standard dose of 25mg a day and then increase it to 50mg a day after two weeks if there has not been much improvement.
How long will I need to take agomelatine?
You and your doctor should talk about how long you need to take agomelatine.
Most people take it for about six months. If you doctor prescribed you agomelatine for depression, you should probably take it for at least six to nine months, otherwise your symptoms can come back.
People who have had low mood or depression more than once may take agomelatine for a couple of years or more. This is to prevent the depression or low mood from returning.
Never stop taking agomelatine suddenly, as this may cause the low mood or depression to return. Ask your doctor or pharmacist for advice on how to stop taking it safely.
It can take a month before this medication has its full effect and you see positive results. By the end of the first month, you should feel your mood lift, have more interest in things and start to enjoy things you used to enjoy again. Let your doctor know if you do not feel better after a month.
If you do not feel any different after a month and are already on 50mg a day, you may need something different. Carry on taking the medicine and go back to your doctor as soon as possible.
Your doctor needs to know if...
You need to talk to your doctor or pharmacist before taking agomelatine if you have, or have ever had:
Your doctor should test your liver function with a blood test before you start taking agomelatine. You should then have follow-up blood tests after three, six, 12 and 24 weeks of treatment. This is because up to one in 400 patients on the higher dose of agomelatine may need to stop treatment due to liver enzyme changes.
Let your doctor know if you have problems eating some sugars or dairy (milk-based) products, as the Valdoxan brand of agomelatine contains lactose.
How can agomelatine be taken?
Agomelatine only comes in the form of 25mg-strength tablets.
You should only take agomelatine as agreed with your doctor
You will get the best effect from agomelatine if you take it regularly every day at the dose prescribed by your doctor.
Make sure that you know your dose. If it's not written on the label, check with your pharmacist or doctor.
You should start by taking agomelatine in the evening. This will help with your sleep.
To make sure you take your medication at the same time every day, try to get into a routine, like taking it when you have supper or brush your teeth.
You can take it before or after food - it doesn't matter.
Swallow the tablet with a drink of water or liquid - if you chew it, it tastes bitter.
The Valdoxan brand of agomelatine may not be suitable for you if you have problems eating some sugars or dairy (milk-based) products, as it contains lactose.
What if I miss a dose?
If you forget to take a dose, then just take it as soon as possible. However, if you realise you forgot to take your last dose by the time you are due to take your next dose, only take your next dose.
Do not take a double dose.
What will happen if I forget to take my agomelatine?
If you forget to take your agomelatine for a few days, you may start to lose any positive effects you have seen while taking it.
If you want to stop taking agomelatine, please speak to your doctor first, as it is better to stop taking it under medical supervision.
Stopping the use of agomelatine
Stopping the medication causes the balance of chemicals in the brain to change.
When you start taking agomelatine, the brain adjusts to having a higher level of melatonin and serotonin around. If you stop taking the medication suddenly, the levels of these chemicals in the brain will change, and your brain can take a while to adapt to this change.
Stopping this medication quickly is unlikely to cause uncomfortable symptoms, but you may lose any positive effects you have seen while taking it.
You will not get addicted to this medication.
You can stop taking agomelatine safely with the help of your doctor.