![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 67. Go back in thread:
Posted by Marty on June 30, 2008, at 17:33:43
In reply to Re: That's very interesting, considering..., posted by WickedGirl on June 30, 2008, at 16:58:06
> Shoot. Meant to say Servier. Don't know why I typed Survector. ARGGGHHH! I need brain help!
I heard ORGASMS was good for womans memory ;)
In fact I think that's the reason woman always remember me. XDTried Nootropics ?
/\/\arty
Posted by WickedGirl on June 30, 2008, at 18:43:29
In reply to The truth about Tianeptine (Stablon) » WickedGirl, posted by Marty on June 30, 2008, at 17:31:10
ROTFLMAO Marty!!! Any orgasms.....teeheehee.
OK Mr. Grouchy (kidding), you have explained several issues with Amineptine way better than I could (hence my desire for Tianeptine). However, I will tell you right now that I know ZERO women (myself included) who have any increase in desire on SSRI's or SNRI's thank you very much. I have also read only about women who all had the same experience as me on these drugs....the complete and permanent death of the desire for sex. I have not taken an anti-depressant (other than a one day attempt at Cymbalta) since 1997, and I have never regained my sex drive in all those intervening years. I used to be quite frisky....took Prozac (amongst others) and the sex drive was dead in a week. Yes, I know it is supposed to take six weeks to have an effect. Well not with me. So boo-hoo....I have lost my sex drive, and I wouldn't mind something to make me a raving sex fiend once in a while instead of a cold, dead fish.
You most definitely stated more of the facts in general than I did, but I also have done plenty of reading where the authors made some very good cases about why Amineptine was not brought to this country and then Tianeptine. Neither is an SSRI, so the FDA did not need to wait until we came up with our own at all before approving one of the Servier drugs. They just didn't want to. As a woman in this country, I have some significant insight into how we are treated by the predominantly male medical establishment. You would think a bunch of horny women running around would be a good thing, but from I have read, and from the blatant, in-my-face lying done to me by the male doctors (oh no...there isn't any sexual dysfunction...in fact this may increase your libido), that is the last thing the medical community and the FDA want. Now, I seriously doubt that all women would end up like that from Amineptine, but we will never know...now will we. <pout, pout>
Anyway, thank you for the private message as well. I will keep you informed, and I look forward to reading more about your thoughts here. ;P
Posted by WickedGirl on June 30, 2008, at 18:46:24
In reply to Re: That's very interesting, considering... » WickedGirl, posted by Marty on June 30, 2008, at 17:33:43
Teehee again. You know...I tried Paracetam for a while, and I swear it made me bitchy (ok, ok bitchier). I was really grouchy onit, so I don't remember the libido thing. I take a lot of supps on a regular basis though. I have even tried things like Tribulus, Horny Goat Weed, Damiana, Maca, etc. No dice. Adderall makes the sex drive go up, but I don't want to take that permanently. Besides, the longer you take it, the more the tolerance builds and it stops working the same anyway.
Posted by Sigismund on June 30, 2008, at 23:06:49
In reply to Re: That's very interesting, considering..., posted by WickedGirl on June 30, 2008, at 16:09:53
I'm hoping tianeptine has just enough side and adverse effects to pass muster.
Posted by Molybdenum on July 3, 2008, at 6:06:57
In reply to Re: That's very interesting, considering..., posted by WickedGirl on June 30, 2008, at 16:09:53
> Oh its a conspiracy Racer. For sure. The government and FDA are determined to prevent any drug that actually enhances the libido in any way (not just whether a man can get it up mind you) from making it to market here. They will say and do anything to prevent that.
You're spot-on WickedGirl, and here's proof:
In honour of the great & now unfortunately dead Kurt Vonnegut, here's a quote from his story "Welcome To The Monkey House" that I hope you will enjoy:) :
"...ethical birth-control pills, the only legal form of birth control, made people numb from the waist down.
Most men said their bottom halves felt like cold iron or balsa wood. Most women said their bottom halves felt like wet cotton or stale ginger ale. The pills were so effective that you could blindfold a man who had taken one, tell him to recite the Gettysburg Address, kick him in the balls while he was doing it, and he wouldn't miss a syllable.
The pills were ethical because they didn't interfere with a persons ability to reproduce, which would have been unnatural and immoral. All the pills did was take every bit of pleasure out of sex.
Thus did science and morals go hand in hand."
Posted by satsumas on July 3, 2008, at 13:35:29
In reply to Re: That's very interesting, considering... » WickedGirl, posted by Molybdenum on July 3, 2008, at 6:06:57
great thread. I wanted to try tianeptine but my doctor suggested desipramine first as he hadn't had much experience with tianeptine and said that a well known bipolar researcher at Stanford wasn't all that enthused about tianeptine's efficacy in BP depression.
i'm now in the process of tapering up on desipramine (at 75, dr says eventually i should be at 125 or 150) and going down from effexor (at 112.5, coming off from 300, where I finally felt good for the first time in 2 years, but had slight hypomania and strong cravings and apathy).
Where I am right now is feeling pretty blah, but with a bit more energy (assume that's desipramine) but i don't feel the "okayness" and lack of obsessive thoughts, and optimism and excitement and capcity for pleasure that I did when effexor was at 300 (which i'm assuming was from the serotonin effects).
MY QUESTION is: Is it OK to take desipramine with tianeptine? My Dr. hinted that they both are effectively doing the "same thing" with tianeptine increasing norep via its decrease of serotonin, but i'm not so sure about that. Does anyone have any experience with this combo?
I feel like I definitely need something for serotonin, but don't want to go the MAOI route, and i am sick of the SSRIs, and in fact any serotonin reuptake mechanism (even a serotonin based TCA).
Thanks
Satsuma
Posted by Quintal on July 3, 2008, at 15:14:00
In reply to Tianeptine + Desipramine, posted by satsumas on July 3, 2008, at 13:35:29
I am interested in this question too because I will probably have to switch to lofepramine (metabolizes into desipramine) when I run out of tianeptine.
>I wanted to try tianeptine but my doctor suggested desipramine first as he hadn't had much experience with tianeptine and said that a well known bipolar researcher at Stanford wasn't all that enthused about tianeptine's efficacy in BP depression.
I have bipolar I and tianeptine has worked for me. It's the only antidepressant that has worked consistently.
>Is it OK to take desipramine with tianeptine?
Yes, I think so. There isn't a great deal of information about potential interactions with tianeptine though.
>y Dr. hinted that they both are effectively doing the "same thing" with tianeptine increasing norep via its decrease of serotonin, but i'm not so sure about that.
I don't think so. It doesn't feel like a nordarenergic drug in any way to me. I suspect he just doesn't want you to take tianeptine, period.
>Does anyone have any experience with this combo?
No, but I did take it with reboxetine with awful results, but that turned out to be just the reboxetine.
Q (Formerly Horned One)
Posted by Marty on July 3, 2008, at 16:01:39
In reply to Re: Tianeptine + Desipramine, posted by Quintal on July 3, 2008, at 15:14:00
> I am interested in this question too because I will probably have to switch to lofepramine (metabolizes into desipramine) when I run out of tianeptine.
I don't get it. Why would you run out of Tianeptine ?
/\/\arty
Posted by Quintal on July 3, 2008, at 16:49:20
In reply to Re: Tianeptine + Desipramine, posted by Marty on July 3, 2008, at 16:01:39
Because obviously I will run out when I've taken the last of the tablets. I don't have an indefinite supply. It's too expensive for me to keep on buying it long term, so I'll have to try an alternative that's available on prescription. Tianeptine was only a stopgap to help cover me until I got a new consultant.
Q
Posted by Marty on July 3, 2008, at 16:54:02
In reply to Re: Tianeptine + Desipramine » Marty, posted by Quintal on July 3, 2008, at 16:49:20
> Because obviously I will run out when I've taken the last of the tablets. I don't have an indefinite supply. It's too expensive for me to keep on buying it long term, so I'll have to try an alternative that's available on prescription. Tianeptine was only a stopgap to help cover me until I got a new consultant.
Ok but how many AD did you try so far ?/\/\arty
Posted by Quintal on July 3, 2008, at 17:07:34
In reply to Re: Tianeptine + Desipramine » Quintal, posted by Marty on July 3, 2008, at 16:54:02
Paroxetine
Fluvoxamine
Fluoxetine
Sertraline
Citalopram
Escitalopram
VenlafaxineMirtazapine
Dothiepin
Imipramine
Melitracen
ReboxetineMoclobemide
Selegiline
Isocarboxazid
TranylcypromineI think that's them all. So, practically everything in the book bar Nardil.
Q
Posted by Marty on July 3, 2008, at 17:52:50
In reply to Re: Tianeptine + Desipramine » Marty, posted by Quintal on July 3, 2008, at 17:07:34
After more than 15 ADs you finally found something that's working for you and you're thinking about switching again for "more of the same" of what didn't work the FIRST 16 TIMES ?!!
Sorry, but I'm shocked. I guess you are, like many others here including me, living with very little money for not having the choice to loose the only thing that has worked for you after so much suffering. I know because I, for one, would prefer not having a TV/Cable/Internet/Car etc than not having the money for HAVING MY BRAIN/LIFE BACK !
How much does Tianeptine cost you per month ?
Don't be shy to NOT answer the following questions as it's personnal: how old are you ? m or f ? where in the world are you living in ?Feel free to babblemail me if you prefer.
If I was Bill Gate or something I would, by empathy, send you a truck loaded of this sugar coated wonder... but I'm so broken that I, too, having difficulty paying for it myself.
/\/\arty
> Paroxetine
> Fluvoxamine
> Fluoxetine
> Sertraline
> Citalopram
> Escitalopram
> Venlafaxine
>
> Mirtazapine
> Dothiepin
> Imipramine
> Melitracen
> Reboxetine
>
> Moclobemide
> Selegiline
> Isocarboxazid
> Tranylcypromine
>
> I think that's them all. So, practically everything in the book bar Nardil.
>
> Q
Posted by Quintal on July 4, 2008, at 6:59:59
In reply to Re: Tianeptine + Desipramine » Quintal, posted by Marty on July 3, 2008, at 17:52:50
Dothiepin and tranylcypromine both worked for me. On that basis I'm going to try lofepramine first because it's the TCA with the mildest side effects. Tianeptine doesn't do anything for my energy and motivation. I still lie in bed for hours every morning because I'm afraid of/ too tired to get up and face the day, so I'm hoping the noradrenergic effect of lofepramine will help with that. If lofepramine fails I will probably go back to Parnate. Alternatively I may try adding tianeptine to lofepramine for a while.
I'm male and I live in the UK. Tianeptine costs me around £72 for three weeks supply. As I already said, I will ask my doctor if there is a way of importing it on the NHS, but I very much doubt it. I've taken tianptine many times in the past and can live without it. It was mainly to get me out of a severe depressive episode this time. I'll probably have to limit myself to short courses when I'm very depressed if nothing else works.
Q
Posted by psychobot5000 on July 7, 2008, at 13:13:06
In reply to Re: Tianeptine + Desipramine » Marty, posted by Quintal on July 3, 2008, at 17:07:34
> Paroxetine
> Fluvoxamine
> Fluoxetine
> Sertraline
> Citalopram
> Escitalopram
> Venlafaxine
>
> Mirtazapine
> Dothiepin
> Imipramine
> Melitracen
> Reboxetine
>
> Moclobemide
> Selegiline
> Isocarboxazid
> Tranylcypromine
>
> I think that's them all. So, practically everything in the book bar Nardil.
>
> Q
Have you considered trying a dopamine agonist (i.e. pramipexole or requip)? I have a similar medication history, and pramipexole was recommended to me by a depression/anxiety specialist.I do know a cheap tianeptine source - it (thankfully) allowed me to fit tianeptine into my budget. If anyone's curious about it, feel free to babblemail me - I'd be happy to provide the details to other sufferers.
Best,
Psychbot
Posted by satsumas on July 7, 2008, at 13:27:07
In reply to Re: Tianeptine » Quintal, posted by psychobot5000 on July 7, 2008, at 13:13:06
can you talk about your experiences with tianeptine? how you felt when you started, your current dose, subjective experiences, comparisions with other drugs, and whether you feel it is actually working "serotoningenically" (e.g., reducing obsessive thoughts, inducing optimism, self-esteem, etc.)?
also, are you just using it with pramipexole right now?
Posted by psychobot5000 on July 7, 2008, at 15:00:57
In reply to Re: Tianeptine » psychobot5000, posted by satsumas on July 7, 2008, at 13:27:07
> can you talk about your experiences with tianeptine? how you felt when you started, your current dose, subjective experiences, comparisions with other drugs, and whether you feel it is actually working "serotoningenically" (e.g., reducing obsessive thoughts, inducing optimism, self-esteem, etc.)?
>
> also, are you just using it with pramipexole right now?I take it alone, actually. The doc I regularly see is not particularly inclined to experimental treatments like pramipexole, and I thought the side-effects would likely be too burdensome.
As for whether it's working 'serotonergically,' I don't really believe so. I mean, I imagine its effects on serotonin cause the antidepressant effects, but I think these are changes 'further down the line.' Probably adaptive changes the brain makes - something like that. In my experience noradrenergic drugs, generalized monoamine drugs (MAOis), serotonin-increasing drugs, and the one serotonin-reducing drug all do about the same thing, just with different side-effects. This tells me that the mechanism of action probably isn't serotonin. Also, if I take an SSRI, my serotonin levels increase greatly within an hour or two, but my mood doesn't change for days, weeks, or months. Same for almost all patients.
But as for the specifics you were wondering about, I find tianeptine does reduce obsessive/anxious thinking pretty substantially. It doesn't have a direct effect on self-esteem or optimism, I would say, but lifts my whole mood a modest amount. Those are probably the primary effects I've observed.
Posted by satsumas on July 7, 2008, at 16:19:55
In reply to Re: Tianeptine » satsumas, posted by psychobot5000 on July 7, 2008, at 15:00:57
Hmm, yeah realize the whole downstream stuff. Thing is, i've always noticed a very quick response to effexor, moving the dose from 225 to 300 within a few days makes a marked difference immediately, for example.
i've definitely noticed for example effexor having very clear self-esteem and anti-obsessive, pacifying qualities, whereas emsam, cymbalta, lamictal, wellbutrin, and (so far) desipramine have not had that affect to such a degree. the other drugs can be activating or pull me out of suicidal depression, but only bringing me back to a blah sort of state.
does tianeptine have any of the SSRI-type side effects, like anhedonia, apathy, and sexual problems in your experience? and what dose do you take, how ong did it take to see a difference?
thanks so much for your help
sat
Posted by Marty on July 7, 2008, at 16:35:46
In reply to Re: Tianeptine » psychobot5000, posted by satsumas on July 7, 2008, at 16:19:55
> does tianeptine have any of the SSRI-type side effects, like anhedonia, apathy, and sexual problems in your experience? and what dose do you take, how ong did it take to see a difference?
Tianeptine has been the med with the less side-effects and I took about 25 meds in the last 10 years. Sexual side effect ? ZERO. anhedonia and apathy neither. .. the only thing I felt the first 2 weeks was a strange kind of background anxiety that came and go... then at about the end of week 2 it was over. I really like Tianeptine and I think it's a shame we (in America) don't have this unique AD.
It seems the high majority of the people is following the 12.5mg x 3 per day .. but some go for 12.5mg x 4 per day. Oh.. and there's that woman who took for one year about 3000mg (!!!.. I repeat THREE THOUSAND MGs) per day because she had some addiction problems and was trying to have a buzz out of Tianeptine! .. I guess it's fair to presume that she wasn't feeling 'ahedonia' and 'apathy' on that dosage :P
BTW, I'm VERY sensitive to side effects and that's why I almost tried them all. (minus TCAs which obviously aren't for the side-effect-sensible people like me.. that said I tried the MAOIs but that's another story) ...
/\/\arty
Posted by satsumas on July 7, 2008, at 16:44:43
In reply to Re: Tianeptine » satsumas, posted by Marty on July 7, 2008, at 16:35:46
can you compare it to S/NRIs like effexor or desipramine (if you've tried it)? As powerful? more/less "serotonin-like" (e.g., reduction of obsessions, positive self-esteem, optimism)?
My dr. is not sure about tianeptine and moved me from effexor to desipramine, but I can most definitely feel the lack of serotonin-related action, so i'm looking for something that works on serotonin system without being a SSRI and i'm not quite willing to do an oral MAOI (Emsam gave me terrible anxiety and made me a little too smart for my own good, to say nothing of the sleep disturbances).
Posted by Marty on July 7, 2008, at 17:03:07
In reply to Re: Tianeptine » Marty, posted by satsumas on July 7, 2008, at 16:44:43
> can you compare it to S/NRIs like effexor or desipramine (if you've tried it)? As powerful? more/less "serotonin-like" (e.g., reduction of obsessions, positive self-esteem, optimism)?
Didn't tried Desipramine. For me it doesn't feel like Effexor at all. In fact Effexor wasn't good for me and I was feeling quite strange. It's difficult to compare Tianeptine to an SSRI or any other AD out there. It's not a very strong "feel good" drug in the "pleasurable" sense .. while it doesn't sounds very good in theory in practice you may like to feel normal and not 'too much good' .. normal isn't supposed to feel 'serotonergic' all the time, right ? I enjoy normality for the first time in 10 years .. confidence in myself is overinflated but just well adjusted and my perception of reality isn't abnormally too easy/fantastic/sweet etc.. it's just LIFE .. but the normal and worth living version, not the depression/anxious/psychosis-borderish version and not the everything-is-perfect-and-so-I-dont-care-about-anything serotonergic version which in the long run mostly brings you into ahedonia/apathy .. you can't have the serotonergic effect you describe and seems to like without the ahedonia/apathy catching you back after a while... that's the negative part of the serotonergic reuptake inhibition hack. Life highs feel high because of the lifes low which feel low etc... you can't be always high .. because without some lows the brain adapt itself to make the highs the new lows.
> (Emsam gave me terrible anxiety and made me a little too smart for my own good, to say nothing of the sleep disturbances).Too smart ? wow.. I see how it can be a bad thing but that sounds like a nice side effect! Actually Tianeptine makes me smarter probably because it reduce (abolish?) all of the attention deficit kind of symptoms.. since I'm on it I'm able to do intellectual stuff I wasn't able to even remotly touch in the last decade. Talk about a perfect self esteem boost :) Can you describe what it was for you to feel smarter on Emsam ? any exemples ? how was it bad for you ? ...
also a little background on your diagnosis could make me think about what could interest (or discourage you) about Tianeptine./\/\arty
Posted by Quintal on July 7, 2008, at 17:10:03
In reply to Re: Tianeptine » Quintal, posted by psychobot5000 on July 7, 2008, at 13:13:06
Yeah, I have some pramipexole. I find it useful for when I'm coming off opiates abruptly, it suppresses the withdrawal symptoms. It tends to give me restless legs and sleep disturbance on its own, so that's why I don't take it long term.
Q
Posted by satsumas on July 7, 2008, at 17:50:07
In reply to Re: Tianeptine » satsumas, posted by Marty on July 7, 2008, at 17:03:07
Thanks so much for your help. What you described is exactly why i dont want to go back on effexor or cymbalta. tended to work at first, then poop out, and just give me side effects (apathy) with no real help in the self-esteem department. so i would just start feeling bad about my lack of motivation, causing mood to plummet anyway.
but i do feel like i need some action on serotonin since i'm prone to obsessive negative thinking, irrationally negative self-image, and a deep, irrational pessimism and hopelessness.
tend to think of mood like a string held between two hands. the effexor can raise the string vertically, but it also makes it taut, so you can't feel negative events or positive events, which in the long run generates the apathy and anhedonia, and ocne you recognize it, is depressing in and of itself, so the string then lowers...but it's still taut. and then at some point, if something bad happens, and stuff has been piling up since it doesn't bounce off the string (OK maybe analogy is breaking down here), the string just frayes and eventually splits...at least in my condition, all my terrible depressive breakdowns have been precipitated by what i consider to be incomplete "processing" of emotionally charged events while on antidepressants, all piling up, until at some point, there is a break. proverbial straw on the camel's back.
i want something that increases the string, but doesn't make it taut -- so my mood is still responsive, but it's baseline is higher than the depths where it has been. i'm hoping tianeptine can do that.
my background. formally diagnosed with BP2, and it's been 95% depression. only two or three hypomanias in the past 5 years, all induced by antidepressants. most recent one lasted about a week and was a lightweight hypomania that went away when i reduced my effexor dosage.
have tried effexor, which worked well for a long time, but i didn't realize the negative effects of anhedonia, apathy, lack of motivation, etc. until too late. also felt it caused cognitive dulling after 18 months of it, combined with lamictal.
then tried wellbutrin, cymbalta, lamictal both on its own and as augmentor, and emsam. also tried provigil and ritalin as augmenters for attention -- both helped, but i hated the speedy feeling of ritalin. felt like i just hyperfocused on whatever was in front of me, which was not necessarily the most useful thing to do.
wellbutrin and cymbalta and effexor all kinda worked, but never got complete response, and had side effects, primarily anhedonia and lack of concentration and zero romantic interest or desire (but the mechanical aspect of libido worked fine, go figure)
emsam gave me lots of energy and what i considered to be an increase in my "free will". improved attention, drive, but caused unrelenting anxiety and probably a touch of psychoticly-smart thinking. would theorize a lot about my past, my family psychological dynamics, business ideas, etc. it felt a bit hypomanic, but without the euphoria. didnt' have much of a serotonin impact, as i still felt bad, low self esteem, etc. worsened obsessive thinking (perhaps thats part and parcel of the smart stuff).
i'm a knowledge-worker as they say and may be going back for my ph.d. someday, but emsam isn't the type of drug i would really take if i was trying to come up with the next theory of relativity. i think the fact that it made me smarter was really just a form of dysphoric hypomania combined with pre-existing anxieties about my life and future.
currently taking lithium, mirapex, desipramine (tapering up, currently at 100), effexor (tapering down, at 75). if i added tianeptine, it would be in addition to / replacement for the desipramine.
originally i thought mirapex helped my desire and anhedonia aspects, but now i'm not so sure, i think it was just the fact that i was coming out of a suicidal depression and moving up very quickly to a high dose of effexor. but i'm keeping it, as i think it has lots of potential, and once i get the other meds stable i will want to experiment with the dosage.
thanks for your help, i'm really quite excited about the prospect of tianeptine being the right drug for me, and i'm just so resistant to going back on an S/NRI or even serotonin-uptake TCA for the exact reasons you described.
thanks,
satsuma
Posted by Marty on July 7, 2008, at 22:16:13
In reply to Re: Tianeptine » Marty, posted by satsumas on July 7, 2008, at 17:50:07
> Thanks so much for your help.
Again, my pleasure. :)> What you described is exactly why i dont want to go back on effexor or cymbalta. tended to work at first, then poop out, and just give me side effects (apathy) with no real help in the self-esteem department. so i would just start feeling bad about my lack of motivation, causing mood to plummet anyway.
Been there, done that, dont want to go back !
> but i do feel like i need some action on serotonin since i'm prone to obsessive negative thinking, irrationally negative self-image, and a deep, irrational pessimism and hopelessness.
I understand. Tianeptine is a SSRE (Selective Serotonin Reuptake ENHANCER) which means it does the opposite of the SSRIs. Now you may think opposite mechanisms of action = opposite effects and you would be right to some extent -> Side effects aren't there ! BUT some of the 'serotonergic' effect is still there plus other effects I never felt on other Serotonergic drugs. After a couple days it start to be anxiolitic just like most SSRIs and while I'm not Dx with OCD I have some tendencies which I feel are better managed (less intrusive thoughts etc).
BTW, I'm BP2 which like you only has been hypomanic BECAUSE of some ADs. Also I have self-esteem, distorted perception of myself in my head and I'm having social phobia. From what I read from your post we are mostly alike. While this isn't telling us how good Tianeptine would be for you I think it's interesting to that point out.I think you should give it a try but there's 2 things that bugs me to be honnest:
1. I fear you would quit it in the first day before it had the time to fully work. (at LEAST 3 weeks would be good) And that's because it can increase some of your symptoms in those first days AND also because it doesn't feel like anything you've tried. Tianeptine does a lot of interesting stuff in your brain (ie: reverse longterm depression induced brain atrophy, grow new neurons and makes news connections between neurons in the regions that regulate mood and anxiety etc... ) but you need to give it time... a thing many people here on Psycho babble didn't give enough and so failed on it.
2. I wonder if your other meds could couteract/modulate/etc Tianeptine effect. This is very difficult to predict. But it's not like you were on some antipsychotics .. It should be okay.
> emsam gave me lots of energy and what i considered to be an increase in my "free will". improved attention, drive, but caused unrelenting anxiety and probably a touch of psychoticly-smart thinking. would theorize a lot about my past, my family psychological dynamics, business ideas, etc. it felt a bit hypomanic, but without the euphoria.
Already felt like this too. Something is working better to some extent when you're like this it comes too too strong and unbalanced and it begins to feel a bit crazy (obsessional?). For me it felt like there was something else that should have smooth and balance this kind of mental energy and so keep it sane.. that's all part of the Bp2 disorder. With Tianeptine (damn, it start to sounds like an advertisement) I feel motivated and smart BUT leveled and quite stable. When I felt this the first time I was thinking that this thing I just decribed (the kind of hypomania) was coming back and that it would worsen with time but it didn't happen. Motivation, projects, ideas all came back and I was really afraid of thinking like a maniac again.. but this time it's just me. I've always being an idea/project guy, even as a healthy kid.. and after all those unmotivated, inactive years it's HARD TO LEARN that those feelings are NORMAL AGAIN.. that It's OKAY to have the desire and will to make some projects and want to do things with my life. I think while living Bp2 you get so used to check yourself for abnormal high energy behaviour & abnormal thinking 'excited' thought process etc that you begin having difficulties reconizing those thing at an HEALTHY LEVEL/TYPE in yourself if you experience it. Anyway.. I can't be sure for others but it's definitively like this for me.
> didnt' have much of a serotonin impact, as i still felt bad, low self esteem, etc. worsened obsessive thinking (perhaps thats part and parcel of the smart stuff).Emsam "increase levels of dopamine" which in turn by complex neurological mechanism "DECREASE Serotonin levels". It's not what's usually best for OCD/Anxious/phobic people! but like everything else you can find exception. Relating to Tianeptine, because it's a med in it's own class, the mechanism of action it pretty much unknown (even less than other ADs).. we know a few things but I feel there's ALOT we don't know as it feels like nothing else. Somehow I feel like it does some magic with dopamine and serotonin.. like balancing their increase/decrease in a way that those always feels good. Serotonin = feel good + not motivated/apathy while Dopamine = motivation/desire/energy + anxiety .. balance the 2 and you only have the good effects of both (feel good/ desire) and not the bad (unmotivated/anxiety) .. can't even remotly explain how it would work but I feel it does works that way somehow and somewhere.
> i'm a knowledge-worker as they say
Me too. Software engineer.
> currently taking lithium, mirapex, desipramine (tapering up, currently at 100), effexor (tapering down, at 75). if i added tianeptine, it would be in addition to / replacement for the desipramine.Okay. but you also need to stop the Effexor also. But I think you didn't mention it because it already planned that you stop Effexor for good. Right ? Can you describe what Mirapex does for you ? I didn't have very good experiences with dopamine agonist like Mirapex and felt it was making me, paradoxally/ironicly, unmotivational and depressed.
> as i think it has lots of potential
You got me interested. Why ?> thanks for your help, i'm really quite excited about the prospect of tianeptine being the right drug for me
I wish you the best if you try it. If you do please give it time to do its job! Tianeptine is really know to CHANGE AND HEAL your brain and reverse what depression did in the long term to your hypothalamus/hypocampus/amygdala but it needs time... and that could be a long and maybe even painful time if it induce some worsening of your condition in the first few weeks. BUT.. if it could do for you what it did for me.. I assure you.. it is worth it! "What is a couple more weeks of pain compare to all you already have been through?" .. this is what I keep telling me when my anxiety was increase at the start and today I can't imagine NOT having go through and so NOT knowing there FINALLY a med working for me!
Could you have something for the possible anxiety increase in the first 3 weeks ? benzo like Xanax would be good ..
/\/\arty
Posted by psychobot5000 on July 8, 2008, at 0:28:48
In reply to Re: Tianeptine » satsumas, posted by Marty on July 7, 2008, at 16:35:46
> > does tianeptine have any of the SSRI-type side effects, like anhedonia, apathy, and sexual problems in your experience? and what dose do you take, how ong did it take to see a difference?
>
> Tianeptine has been the med with the less side-effects and I took about 25 meds in the last 10 years. Sexual side effect ? ZERO. anhedonia and apathy neither.
>
My experience was very similar. No sexual side-effects or apathy or anhedonia (though I don't recall SSRIs giving me those. They didn't help with the apathy and anhedonia I already had, but they didn't give me any more). I find it remarkably side-effect-free. Nothing to speak of, really. I take 12.5mg 3 times a day - tried double that for a few weeks once, but it didn't help. I would say it's right about as powerful as Effexor, no more, no less. Just without the S/Es. I also consider myself sensitive to side-effects, and I'm grateful for tianeptine."but i do feel like i need some action on serotonin since i'm prone to obsessive negative thinking, irrationally negative self-image, and a deep, irrational pessimism and hopelessness."
I have similar problems, and the tianeptine helps reduce these symptoms to being manageable - by maybe 60% or so. That's as much or more as I can remember getting from any other antidepressant, and possibly better than I got with SSRIs or Effexor (which, for me, unfortunately caused nearly as much anxiety as they relieved, from what I remember). I couldn't begin to predict whether it might be as effective for you.
Good luck,
Psychbot
Posted by satsumas on July 8, 2008, at 18:03:39
In reply to Re: Tianeptine » satsumas, posted by Marty on July 7, 2008, at 22:16:13
thanks again for the helpful post. i hope it doesn't have negative side effects to start with, as my mood is already starting to slip now that im down to <75mg of effexor. anxiety is creeping up but there are always the benzos.
honestly, at this point i'm not sure if mirapex is doing anything positive. at first i suspected it was doing something for anhedonia and the "desire" connection -- basically, why aren't the things i intellectually like to do, things i know i enjoy doing, not actually motivating? i know it sounds just like motivation but i characterized it as slightly different to my pdoc and he responded well to the theory...something relating to the avolition aspect of parkinsons.
but even if i didn't make that up and actually did feel something, it's extremely subtle, and i dont feel it anymore, and it could have been just due to coming up QUICKLY on a high dose of effexor.
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