Agomelatine(Valdoxan) is a newer form of antidepressant/antianxiety medication which is also particularly good as a sleep assisting medication. It works in a different way to other mood medications – working on what we call the ‘Melatonin’ system.
The melatonin system is actually a natural system in everyone’s body and it helps to control whether we are awake or asleep. For example, some people will often try to take melatonin at night to help them sleep. If you have ever had ‘jet lag’ where you come back from overseas and your body has lost its normal rhythms – we are often awake all night and sleepy all day. This is also because our melatonin system is all confused!
For people experiencing pain, sleep can often be difficult. It can either be from worry, stress, anxiety or frustration about our pain – or the pain itself can either wake us or stop us from getting to sleep in the first place.
Unlike other antidepressant or antianxiety medications, Agomelatine often has very few side effects and can be taken with other mood medications as an add on to improve the antidepressant/antianxiety effects and to help with sleep. This is very beneficial for our patients with pain we as we all need sleep to cope, stay relaxed and for our bodies to heal and regenerate.
There is a very rare side effect of liver injury so we will recommend that you have a liver blood test a few times after starting the medication. If there are any signs ofliver concerns, we may suggest that you cease taking it.
So, what are the downsides? Well, the big limitation currently is the cost. Agomelatine is not on the PBS and therefore can cost approximately $50 / month. The government has not placed it on the subsidised list at this time – mainly because they are already subsidising many other antidepressant/antianxiety medications so did not want to add more. This may change in future.
Given that it is a more expensive medication, I usually recommend that people try it for a month or two and then decide if it is worth it for them. Many people believe the cost is worth it while others may find less benefit and decide to stop using the medication. The only way to find out if it is for you is under the guidance of your health team and trying it if you wish to.
Further information can be from asking your Resolve Pain team or from the links below.
Healthdirect - Australian Government - Information for Valdoxan