Posted by sukarno on November 16, 2007, at 13:24:24
In reply to Re: Tianeptine long term and tolerance » sukarno, posted by fuchsia on November 15, 2007, at 7:30:25
Hi Fuchsia! :-)
I've been on Stablon since late March 2005. I began with 1 tablet taken three times daily. I noticed no effects until the 12th day and the effects were very much like a stimulant effect (similar to adrenaline), but no effects on my heart rate or rhythm. I also felt a throbbing headache similar to the type of headache you would get from abrupt caffeine withdrawal. I had to lower the dose for a few days and raise it (a lot of fine-tuning) until this went away.
The antidepressant effect began a few days after the stimulant/adrenaline-like started. It got better in the long-term. My mood improved, anxiety decreased and the headache disappeared. No more stimulant effects.
This beneficial effect on my mood continued for a month or two and then it seemed to lose some of its efficacy. My depression returned, but not as bad as it was prior to taking Stablon. I then raised the dosage to 1 tablet taken four times daily. Efficacy was restored and this lasted for a few months.
It slightly pooped out again and I didn't raise or lower the dose. Within one week, the depressive symptoms disappeared and efficacy was back to where it was before. It was once again working well. It could have been a rough time in my life.
I tried lowering the dose to 3 tablets/day and then finally 2 tablets/day. I had a panic attack or two (but nothing major in terms of anxiety)..along with a restless feeling like when you quit smoking. Depression began to return, but not severely as it was prior to beginning Stablon.I then raised the dose to 3 tablets/day and without having to wait more than a few days, efficacy was restored. Relief was rapid. I began to think Stablon could be habit-forming at this point and began to have dreams (Stablon, like all antidepressants and psychotropic drugs, can give you vivid dreams) about Stablon. I'd be in a shop in my dream and see boxes and bags of Stablon and that would be the focus of the dream. That happened a lot, but I wouldn't say Stablon is addictive, at least not for me. Habit-forming like smoking, possibly, but not as bad as smoking.
I did experience euphoria a few times when raising the dose or after the third or last dose of the day, but that did not happen often. In fact, that was rare.
To put it this way, I could not imagine a life without Stablon. Perhaps this is because it has helped me, but at the same time, if my funds were unlimited, I'd be tempted to keep raising the dose. Sorry, I didn't mean to give any bad PR about this medication. This is just how I feel. I also think that being on it for a long time makes it more difficult to reduce the dose. I did have cravings for it when I tapered. I think it might also trigger compulsive behavior, since it does modulate the D2/D3 (important here is the D3 dopamine receptor). I've felt the urge (strong urge) to go out and gamble, but I've never gambled in my life and never had those thoughts prior to this.
Interestingly, it seems to have reduced my urge to smoke. I'm a non-smoker and have been for 15 years, but the urge still bothers me. However, on Stablon it seems that the urge is lower. I'm not sure why. This could be because of Stablon's action on dopamine. Zyban works on dopamine too and helps to curb the urge to smoke.Whenever I did lower the dose for a while and went back to the original dose, I felt my mood restored in a very short time, which was great. There wasn't really much of a delay.
I've found 4 tablets a day to be the right dosage for me. Higher doses have not proved their usefulness. I've tried 2 tablets three times daily and felt little benefit from it. If anything I had some mild stomach pains that never occurred with the 3 or 4 tablet a day regimen.What is your dosage? In the clinical trials they were trying dosages of 25 to 75mg/day (2 to 6 tablets).
If you are on 3 tablets/day you could try increasing it to 4 tablets/day and be sure to space the dose 4 hours apart. 8am, noon, 4pm, 8pm
I've found that to work best for myself anyway. Everyone is different though.Four tablets a day doesn't seem to "poop out", unlike the 3 tablets/day regimen I was previously on. I've been taking 4 tables a day for 2 years.
It might take 2 or 3 months total for the full response.
Beware of any possible dependence. I feel this drug does have habit-forming potential. I never felt that imipramine or fluoxetine had this potential. This could be because it is short-acting and/or because of its action of dopamine, increasing its concentration in the nucleus accumbens (an area that other addictive drugs act on) and frontal cortex. It also accelerates/enhances the reuptake of serotonin, concentrating serotonin in different areas of the brain than other antidepressants.
There's some information here:
http://en.wikipedia.org/wiki/Tianeptine
With all of that said, I think the benefits outweigh the risks of any dependence that may or may not form. Clearly I am better off than I was before I began taking Stablon and I've suffered from depression since 1987.Good luck to you and please keep us informed by posting here. :-)
Best wishes,
Paul
poster:sukarno
thread:474445
URL: http://www.dr-bob.org/babble/20071115/msgs/795474.html