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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by Conundrum on November 1, 2010, at 22:59:47
My pdoc doesn't know I started taking stablon. Its not available in my country. I'm not sure if I should mention it or not. I would like to push for a noradrenergic med that will not interfere with taking stablon. I'm still on remeron and think maybe she will want me to increase that to 60 mgs or stop it all together. I'm not actually too thrilled with stablon. I had this theory that I had way too much serotonin and that a drug that would deplete it would help. I also figured that if this were the case that taking stablon would have some immediate effect. Like if I had so much serotonin that dopamine was being quashed, I would think I would have felt relief immediately. This is just a theory though and may not even be accurate.
On the other hand I responded within 24 hours positively to pristiq. The morning after taking it the world seemed more colorful, I felt a good tingling on the left side of my head, and also experienced an increase in sexual arousal. Like I've mentioned this faded. However it seems to indicate that trying something adrenergic might make more sense then relying solely on tianeptine.
Posted by g_g_g_unit on November 1, 2010, at 23:37:29
In reply to Should I tell my pdoc about stablon?, posted by Conundrum on November 1, 2010, at 22:59:47
I thought about this too, since I ordered a batch of Stablon 2 weeks ago, which I'm waiting to arrive, and am due to meet with a new psychiatrist in a month.
I wasn't thrilled about the idea of taking it unsupervised, so finally settled on asking my GP if he'd let me trial it (I didn't disclose that I had some on the way). He agreed, which is great.
I had this idea that a GP might be more flexible about experimenting than a psychiatrist, possibly, since I wasn't sure if GP's were as susceptible to drug-company hype, although maybe that's just an empty idealization . .
What does Stablon do to you?
Posted by Conundrum on November 1, 2010, at 23:55:15
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 1, 2010, at 23:37:29
> I thought about this too, since I ordered a batch of Stablon 2 weeks ago, which I'm waiting to arrive, and am due to meet with a new psychiatrist in a month.
>
> I wasn't thrilled about the idea of taking it unsupervised, so finally settled on asking my GP if he'd let me trial it (I didn't disclose that I had some on the way). He agreed, which is great.
>
> I had this idea that a GP might be more flexible about experimenting than a psychiatrist, possibly, since I wasn't sure if GP's were as susceptible to drug-company hype, although maybe that's just an empty idealization . .
>
> What does Stablon do to you?
I'm thinking of maybe just saying I'm taking a supplement or something like 5 HTP. It may not seem as irresponsible as ordering something from turkey.The effects I've noticed are subtle. I've taken it for 4 days. I've noticed a little tiredness. Yesterday I doubled the dose just to see what would happen, since it supposedly has short acting immediate effects. I didn't notice anything, which is not surprising since short acting drugs have no effect on my mood.
Sometimes you don't feel as if you've taken anything. Sometimes I dull unobtrusive headache, or just a feeling that something is going on in your head. I believe the true effects of the drug do take sometime to develop, but I think that if it were to work, one might notice some anti anxiety effects right off the bat.
I'm just skeptical about taking 2 whole months on a drug that is considered fairly weak. I may want to start something else at the same time. I just thought I might notice something right off the bat, like some people notice with ritalin or oxycodone. I haven't noticed anything so far. No significant side effects either.
I'm thinking maybe trying to get a script for desipramine might make more sense since I've had some luck with drugs that increase norepinephrine. Maybe I'll just try to max remeron out to 60mg and see how that is with stablon.
Posted by Phillipa on November 2, 2010, at 0:16:06
In reply to Re: Should I tell my pdoc about stablon? » g_g_g_unit, posted by Conundrum on November 1, 2010, at 23:55:15
I'd discuss your theory with your doc and mention some things you have thought of taking and see what he says and decide from there. Phillipa
Posted by g_g_g_unit on November 2, 2010, at 0:21:09
In reply to Re: Should I tell my pdoc about stablon? » g_g_g_unit, posted by Conundrum on November 1, 2010, at 23:55:15
Have you tried Dexedrine/Adderall?
Maybe the acute effects of drugs are different to the long-term, even with NRI's? I've never really lost all my emotions, except via depression, so I can't comment . . clomipramine definitely didn't numb me in the way SSRI's do . . in fact, I felt pretty normal, so maybe Desipramine could help you.
I'm the opposite to you though: NRI's drive me crazy (Ritalin, Seroquel, Clomirapmine, Mirtazapine [not an NRI, but still]. Since Stablon antagonizes NE-release in certain parts of the brain, I believe, I was hoping it might help my anxiety.
> > What does Stablon do to you?
> I'm thinking of maybe just saying I'm taking a supplement or something like 5 HTP. It may not seem as irresponsible as ordering something from turkey.
>
> The effects I've noticed are subtle. I've taken it for 4 days. I've noticed a little tiredness. Yesterday I doubled the dose just to see what would happen, since it supposedly has short acting immediate effects. I didn't notice anything, which is not surprising since short acting drugs have no effect on my mood.
>
> Sometimes you don't feel as if you've taken anything. Sometimes I dull unobtrusive headache, or just a feeling that something is going on in your head. I believe the true effects of the drug do take sometime to develop, but I think that if it were to work, one might notice some anti anxiety effects right off the bat.
>
> I'm just skeptical about taking 2 whole months on a drug that is considered fairly weak. I may want to start something else at the same time. I just thought I might notice something right off the bat, like some people notice with ritalin or oxycodone. I haven't noticed anything so far. No significant side effects either.
>
> I'm thinking maybe trying to get a script for desipramine might make more sense since I've had some luck with drugs that increase norepinephrine. Maybe I'll just try to max remeron out to 60mg and see how that is with stablon.
>
>
Posted by Conundrum on November 2, 2010, at 0:32:18
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 2, 2010, at 0:21:09
I have never tried dexedrine or adderall, I'm intrigued and a little worried about trying them, because if they don't work, no shorter acting drug probably will.
I agree that short term effects may be different than long term. Like with pristiq I took my first dose around 3 PM and then the next morning around 9 AM I started to notice something. It became more pronounced the next day. So I might need more of an accumulation of neurotransmitters than a stimulant can offer in a few hours.
So I'm gonna finish of this pack and if I have enough maybe order another. From what I have read, this med really does decrease NE, (makes me wonder why I bought it) so it may be helpful to you.
I remember when mirtazapine kicked in initially I felt really good. I was transcribing music in my head at my desk at work, but it only lasted a couple days and then I guess the receptors up or downregulated back to normal.
I wouldn't say I lost all my emotions, but I feel that I am functioning emotionally on a subhuman level.
I kinda wished I had tried effexor instead of pristiq, since my understanding is it works better as the dose is increased, the same cannot be said as generally with pristiq.
> Have you tried Dexedrine/Adderall?
>
> Maybe the acute effects of drugs are different to the long-term, even with NRI's? I've never really lost all my emotions, except via depression, so I can't comment . . clomipramine definitely didn't numb me in the way SSRI's do . . in fact, I felt pretty normal, so maybe Desipramine could help you.
>
> I'm the opposite to you though: NRI's drive me crazy (Ritalin, Seroquel, Clomirapmine, Mirtazapine [not an NRI, but still]. Since Stablon antagonizes NE-release in certain parts of the brain, I believe, I was hoping it might help my anxiety.
>
>
>
>
> > > What does Stablon do to you?
> > I'm thinking of maybe just saying I'm taking a supplement or something like 5 HTP. It may not seem as irresponsible as ordering something from turkey.
> >
> > The effects I've noticed are subtle. I've taken it for 4 days. I've noticed a little tiredness. Yesterday I doubled the dose just to see what would happen, since it supposedly has short acting immediate effects. I didn't notice anything, which is not surprising since short acting drugs have no effect on my mood.
> >
> > Sometimes you don't feel as if you've taken anything. Sometimes I dull unobtrusive headache, or just a feeling that something is going on in your head. I believe the true effects of the drug do take sometime to develop, but I think that if it were to work, one might notice some anti anxiety effects right off the bat.
> >
> > I'm just skeptical about taking 2 whole months on a drug that is considered fairly weak. I may want to start something else at the same time. I just thought I might notice something right off the bat, like some people notice with ritalin or oxycodone. I haven't noticed anything so far. No significant side effects either.
> >
> > I'm thinking maybe trying to get a script for desipramine might make more sense since I've had some luck with drugs that increase norepinephrine. Maybe I'll just try to max remeron out to 60mg and see how that is with stablon.
> >
> >
>
>
Posted by g_g_g_unit on November 2, 2010, at 0:49:42
In reply to Re: Should I tell my pdoc about stablon? » g_g_g_unit, posted by Conundrum on November 2, 2010, at 0:32:18
> I have never tried dexedrine or adderall, I'm intrigued and a little worried about trying them, because if they don't work, no shorter acting drug probably will.
Well, if they help initially, and you're feeling experimental/desperate, you could always try the famed Memantine + Adderall combo, though you'd probably have to obtain Memantine online as well (which is possible).
>
> I agree that short term effects may be different than long term. Like with pristiq I took my first dose around 3 PM and then the next morning around 9 AM I started to notice something. It became more pronounced the next day. So I might need more of an accumulation of neurotransmitters than a stimulant can offer in a few hours.
>Sorry, I meant that maybe the 'color' thing might naturally fade away with more potent NE drugs regardless.
> So I'm gonna finish of this pack and if I have enough maybe order another. From what I have read, this med really does decrease NE, (makes me wonder why I bought it) so it may be helpful to you.
>
> I remember when mirtazapine kicked in initially I felt really good. I was transcribing music in my head at my desk at work, but it only lasted a couple days and then I guess the receptors up or downregulated back to normal.Yeah, as an (ex-)writer, I miss planning pieces in my head. I was always toying around with particular words I might like to use, or spontaneously coming up with metaphors/ideas during the day. It's been forever. At this stage, I've (no pun intended) written that part of me off as irrevocably gone.
>
> I wouldn't say I lost all my emotions, but I feel that I am functioning emotionally on a subhuman level.Yeah, that must suck. Try as it might, I guess psychiatry can't really find new diagnostic models to encompass all the problems it creates.
>
> I kinda wished I had tried effexor instead of pristiq, since my understanding is it works better as the dose is increased, the same cannot be said as generally with pristiq.
>Well, there's no reason you can't still try Effexor right? It's not like requesting Mirapex or something.
Posted by Conundrum on November 2, 2010, at 1:29:40
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 2, 2010, at 0:49:42
> Sorry, I meant that maybe the 'color' thing might naturally fade away with more potent NE drugs regardless.
Well thats hopeful.
>
> > So I'm gonna finish of this pack and if I have enough maybe order another. From what I have read, this med really does decrease NE, (makes me wonder why I bought it) so it may be helpful to you.
> >
> > I remember when mirtazapine kicked in initially I felt really good. I was transcribing music in my head at my desk at work, but it only lasted a couple days and then I guess the receptors up or downregulated back to normal.
>
> Yeah, as an (ex-)writer, I miss planning pieces in my head. I was always toying around with particular words I might like to use, or spontaneously coming up with metaphors/ideas during the day. It's been forever. At this stage, I've (no pun intended) written that part of me off as irrevocably gone.
>
> >
> > I wouldn't say I lost all my emotions, but I feel that I am functioning emotionally on a subhuman level.
>
> Yeah, that must suck. Try as it might, I guess psychiatry can't really find new diagnostic models to encompass all the problems it creates.
> >
> > I kinda wished I had tried effexor instead of pristiq, since my understanding is it works better as the dose is increased, the same cannot be said as generally with pristiq.
> >
>
> Well, there's no reason you can't still try Effexor right? It's not like requesting Mirapex or something.
>
Thats true, and in fact Effexor might be better since it is a weak dopamine reuptake inhibitor. Perhaps that would help as well, with sufficient NE.
Posted by g_g_g_unit on November 2, 2010, at 2:45:00
In reply to Re: Should I tell my pdoc about stablon?, posted by Conundrum on November 2, 2010, at 1:29:40
>
> > Sorry, I meant that maybe the 'color' thing might naturally fade away with more potent NE drugs regardless.
>
>
> Well thats hopeful.Lol! Sorry, I didn't mean to put a damper on your parade and really lack the proper knowledge base to speculate. But in researching things like Mirapex, I've read that sometimes the acute effects provided by a drug don't really match the long-term effects.. so what I mean is, maybe in chasing one effect in a drug, you might miss the actual therapeutic effect and feel disappointed. Parnate made me feel great for about 3 weeks, before raising the dose induced apathy and numbing. Again, I can't comment on whether this might specifically occur with NRI's, so please don't take my opinion as gospel.
> >
> > > So I'm gonna finish of this pack and if I have enough maybe order another. From what I have read, this med really does decrease NE, (makes me wonder why I bought it) so it may be helpful to you.
> > >
> > > I remember when mirtazapine kicked in initially I felt really good. I was transcribing music in my head at my desk at work, but it only lasted a couple days and then I guess the receptors up or downregulated back to normal.
> >
> > Yeah, as an (ex-)writer, I miss planning pieces in my head. I was always toying around with particular words I might like to use, or spontaneously coming up with metaphors/ideas during the day. It's been forever. At this stage, I've (no pun intended) written that part of me off as irrevocably gone.
> >
> > >
> > > I wouldn't say I lost all my emotions, but I feel that I am functioning emotionally on a subhuman level.
> >
> > Yeah, that must suck. Try as it might, I guess psychiatry can't really find new diagnostic models to encompass all the problems it creates.
> > >
> > > I kinda wished I had tried effexor instead of pristiq, since my understanding is it works better as the dose is increased, the same cannot be said as generally with pristiq.
> > >
> >
> > Well, there's no reason you can't still try Effexor right? It's not like requesting Mirapex or something.
> >
> Thats true, and in fact Effexor might be better since it is a weak dopamine reuptake inhibitor. Perhaps that would help as well, with sufficient NE.
Posted by morgan miller on November 2, 2010, at 11:26:01
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 2, 2010, at 2:45:00
>Parnate made me feel great for about 3 weeks, before raising the dose induced apathy and numbing. Again, I can't comment on whether this might specifically occur with NRI's, so please don't take my opinion as gospel.
Did you try going back down to the dose that didn't induce apathy and numbing?
Posted by Conundrum on November 2, 2010, at 12:59:22
In reply to Re: Should I tell my pdoc about stablon?, posted by morgan miller on November 2, 2010, at 11:26:01
> >Parnate made me feel great for about 3 weeks, before raising the dose induced apathy and numbing. Again, I can't comment on whether this might specifically occur with NRI's, so please don't take my opinion as gospel.
>
> Did you try going back down to the dose that didn't induce apathy and numbing?Yeh I was wondering the same thing.
Posted by Brainbeard on November 2, 2010, at 13:34:08
In reply to Re: Should I tell my pdoc about stablon?, posted by Conundrum on November 2, 2010, at 12:59:22
... a dopaminergic rush for sure. Unless you're built out of concrete.
Posted by hyperfocus on November 2, 2010, at 13:55:07
In reply to Should I tell my pdoc about stablon?, posted by Conundrum on November 1, 2010, at 22:59:47
With drugs like tianeptine you can't measure their effects using a bucket. The base action could be described as raising or lowering the levels of neurotransmitter X, but the truth is we don't have a clue what these drugs do in the brain. From what I've read Stablon and its Servier cousin Valdoxan have extremely complex mechanisms of actions hitting multiple sites in the brain that absolutely no one understands. The action of Stablon could be synergistic with any number of serotonin-enhancing meds, even though they are described as having opposite mechanisms of actions. I found tianeptine together with amitriptyline to be synergistic.
If I were you I'd keep going with the Remeron and Stablon. If you take 3 stablon at once you'll get a short dopamine rush like "everything's gonna be ok" but this isn't the true effect of the med. The real response would take probably at least one or two or three weeks to manifest. My one suggestion would be to take 1x day instead of 3x day. The recommended 3 x day dosage I think is more a logical conclusion out of the drug's short half-life, and not related to effacy. I don't notice a difference between 1 x day and 3 x day Stablon so you could save your pills.
Posted by Brainbeard on November 2, 2010, at 16:42:47
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by hyperfocus on November 2, 2010, at 13:55:07
> With drugs like tianeptine you can't measure their effects using a bucket. The base action could be described as raising or lowering the levels of neurotransmitter X, but the truth is we don't have a clue what these drugs do in the brain.
Close to the truth, but still a bit of an overstatement.
We do know that the net result of tianeptine's effect on serotonin transmission is similar to that of SSRI's. As Doctor Preskorn has observed in an excellent article on tianeptine: 'tianeptine shares with the classical antidepressants the ability to reduce the expression of the SE transporter mRNA and the number of SE transporter binding sites'.*
Several people, including myself, have noticed that tianeptine can flatten mood in a way similar to SSRI's, although more mildly so.
You rightly observe that tianeptine has many mechanisms. As an atypical TCA, tianeptine may have effects on the opioid system similar to other TCA's. For another thing, tianeptine has effects on glutamate. We're not just groping in the dark here.
* Sheldon H. Preskorn, 'Tianeptine: A Facilitator of the Reuptake of Serotonin and Norepinephrine as an Antidepressant?', in: Journal of Psychiatric Practice, Volume 10(5) September 2004, 323-330
Posted by maxime on November 2, 2010, at 22:31:56
In reply to Should I tell my pdoc about stablon?, posted by Conundrum on November 1, 2010, at 22:59:47
I would tell your doctor. He/she needs to know the complete picture. I even tell my pdoc when I start an alternative med. You never know when what you are adding may affect something else you are on.
Posted by Conundrum on November 2, 2010, at 23:16:08
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by maxime on November 2, 2010, at 22:31:56
> I would tell your doctor. He/she needs to know the complete picture. I even tell my pdoc when I start an alternative med. You never know when what you are adding may affect something else you are on.
Have you ever told your pdoc after the fact, when you've already added the alternative piece?
Posted by g_g_g_unit on November 3, 2010, at 0:35:07
In reply to Re: Should I tell my pdoc about stablon?, posted by morgan miller on November 2, 2010, at 11:26:01
>
> Did you try going back down to the dose that didn't induce apathy and numbing?No, because it was obvious that what I was feeling was the initial stimulant effect (i.e. mild euphoria and an increase in drive), rather than a therapeutic effect. The lower doses also did very little for my anxiety.
Posted by ed_uk2010 on November 3, 2010, at 2:54:18
In reply to Groping In The Dark, posted by Brainbeard on November 2, 2010, at 16:42:47
>Groping In The Dark
I guess they came out relatively intact.
Posted by Brainbeard on November 3, 2010, at 5:13:11
In reply to Re: Groping In The Dark » Brainbeard, posted by ed_uk2010 on November 3, 2010, at 2:54:18
> >Groping In The Dark
>
> I guess they came out relatively intact.
Hahaha.Damn idiom/slang... :)
That was more ambiguous than I had meant it to be...
(http://www.thefreedictionary.com/grope)
Posted by morgan miller on November 3, 2010, at 10:13:24
In reply to Re: Should I tell my pdoc about stablon? » morgan miller, posted by g_g_g_unit on November 3, 2010, at 0:35:07
> >
> > Did you try going back down to the dose that didn't induce apathy and numbing?
>
> No, because it was obvious that what I was feeling was the initial stimulant effect (i.e. mild euphoria and an increase in drive), rather than a therapeutic effect. The lower doses also did very little for my anxiety.That sucks..And it makes perfect sense
Posted by Conundrum on November 3, 2010, at 13:01:58
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 1, 2010, at 23:37:29
I've noticed that it does seem to help a little with some anxiety. I was very anxious about a class I'm taking but yesterday was pretty relaxed and everything went well. I probably won't know if it helps with motivation for some time though. Sometimes that comes later with serotonergic drugs or not at all.
I think you might like it, G Unit.
>
> What does Stablon do to you?
Posted by maxime on November 3, 2010, at 19:50:40
In reply to Re: Should I tell my pdoc about stablon?, posted by Conundrum on November 2, 2010, at 23:16:08
>
> Have you ever told your pdoc after the fact, when you've already added the alternative piece?Yes I have. He then will ask me if it is helping. So he doesn't have a problem with that. But if I ever started a prescription med on my own before telling him, he would not be impressed at all. But in Canada it's hard to get meds online without a prescription, it seems to be easier in the States.
Posted by Conundrum on November 3, 2010, at 20:27:25
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by maxime on November 3, 2010, at 19:50:40
Well I told her, she didn't sound to thrilled but I decided it would be better to continue to try this and then see her, because she doesn't know about the drug and wouldn't feel comfortable prescribing another drug with it.
She wished me luck. I hope this doesn't mean if it doesn't work and need to call her she wont' return my call. Ugh I wish I had lied, then I could be taking a drug like desipramine or something that could help me concentrate better in my classes. FML.
> >
> > Have you ever told your pdoc after the fact, when you've already added the alternative piece?
>
> Yes I have. He then will ask me if it is helping. So he doesn't have a problem with that. But if I ever started a prescription med on my own before telling him, he would not be impressed at all. But in Canada it's hard to get meds online without a prescription, it seems to be easier in the States.
Posted by Conundrum on November 3, 2010, at 21:02:11
In reply to Re: Should I tell my pdoc about stablon? » maxime, posted by Conundrum on November 3, 2010, at 20:27:25
F*ck it I know this med isn't gonna help anyway, i should have just lied. Why do I always have to be so frickin honest?
> Well I told her, she didn't sound to thrilled but I decided it would be better to continue to try this and then see her, because she doesn't know about the drug and wouldn't feel comfortable prescribing another drug with it.
>
> She wished me luck. I hope this doesn't mean if it doesn't work and need to call her she wont' return my call. Ugh I wish I had lied, then I could be taking a drug like desipramine or something that could help me concentrate better in my classes. FML.
> > >
> > > Have you ever told your pdoc after the fact, when you've already added the alternative piece?
> >
> > Yes I have. He then will ask me if it is helping. So he doesn't have a problem with that. But if I ever started a prescription med on my own before telling him, he would not be impressed at all. But in Canada it's hard to get meds online without a prescription, it seems to be easier in the States.
>
>
Posted by Phillipa on November 3, 2010, at 21:17:49
In reply to Re: Should I tell my pdoc about stablon?, posted by Conundrum on November 3, 2010, at 21:02:11
Please don't beat yourself up. I would always do the same thing but my situation is a bit different as mine gave me permission "to take whatever I want". I think now that you feel the stablon won't work and had been second guessing desipramine? If so I'd call and say I'm sorry I used poor judgement and I would like to give you the stablon so you know I'm sincere and try desipramine will you trust and forgive me? But this is me. Phillipa
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