Posted by Larry Hoover on December 24, 2004, at 8:53:12
In reply to Re: tianeptine and melatonin Ed-UK or Larry Hoove » jasmineneroli, posted by Franz on December 23, 2004, at 22:11:54
> > Tianeptine ACCELERATES the uptake of serotonin, rather than inhibits its re-uptake, like the SSRI's. So I'm not sure if that mechanism means that the serotonin would then be rapidly further metabolized to melatonin. Thus resulting in more melatonin. I'd be concerned about adding melatonin, without more info from the manufacturer, Servier, in France.
> > I've heard, however, that small doses of melatonin (1 - 1.5mg) can be used to good effect with most regular SSRI'S.
> > Ed-UK or Larry Hoover may know more.
> > Jas
>
>
> Thanks Jas, yes it is difficult to know. I think I will try 1.5mg or less.
>
> I hope Ed-UK or Larry Hoover can read and reply.I'll give you my take on it, but I don't know if there's a flaw in my reasoning or not.
When a neurotransmitter is pumped back into the neuron that released it into the synapse, it is taken into a storage vescicle for re-use. In other words, it doesn't move off to a different part of the brain. It is an efficiency process, one which recycles the neurotransmitter, rather than permitting it to be destroyed by enzymes like MAO or COMT.
The melatonin produced in e.g. the pineal gland is almost certainly produced in situ, in that gland, taking tryptophan past serotonin and on to melatonin. In that synthesis, serotonin is not a product but is instead an intermediate.
By supplying melatonin, you may take some pressure off the mutual demand for tryptophan. You may also prevent the adverse sequelae coming from antidepressant-induced insomnia.
I can't think of a mechanistic reason not to consider the combination, but that doesn't mean that there isn't one.
Starting at a low dose of melatonin still makes sense, as adverse effects of combinations usually are dose-responsive. I'd start at 0.5 mg melatonin, and work up from that. Some people only need such a small dose of melatonin, anyway, and taking too much actually inhibits sleep, via saturation of the receptors.
Lar
poster:Larry Hoover
thread:427416
URL: http://www.dr-bob.org/babble/20041223/msgs/433714.html