![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Dragon Black on August 30, 2007, at 21:10:36
Dear Babbleonians,
Guess who’s back? (think to yourself “Dragon Black”) Just thought I would give you my initial thoughts on tianeptine (Stablon), since due to it I am now apparently out of this, now former, depressive episode. It is day 9 for me. I started at 12.5 mg x 3/day on day 1, went to x 4/day for days 2-8 (except one day I forgot the 4th dose) and now am switching back to x 3 today. I started to feel effects on day 3 – in fact that morning I got the Zang! moment, where it’s like someone turned a light switch on and I know my depression is over. Great mood, super relief, etc. But, I always mini-cycle into and out of my episodes, and remembering what happened to me when I started SAM-e in the spring I refused to get my hopes up (I didn’t expect the downturn after being SO relieved to be out of my depression and it hit hard and was completely demoralizing. Didn’t realize at the time that I was on my way out and only had to experience a couple of bad days). Sure enough, by the afternoon I felt less than special and was cozily nestled back down in the dungeon for days 4-7. Yesterday I felt quite a bit better, which was bizarre given that I had gotten quite drunk the night before (yes, I know, I know; this is a whole ‘nother story). I managed to stay sober last night and go to bed at a decent hour so as to stop sabotaging my AD trial (something that I would not have been able to do two days earlier, when my depression was crescendoing, it’s worth noting), and today I’ve felt more or less very good all day and I know that it’s over. It’s quite possible I’ve got another mini-cycle in my future but I doubt it. This has been a really weird depression for me and there are lots of confounding factors that make it difficult to talk about tianeptine in isolation - I’m tempted to try to cover them but I don’t want to write a book. However, suffice it to say that in general, my life circumstances have certainly not improved since I started it, I’ve gone out of my way to sabotage myself (by eating and drinking like I’m literally trying to kill myself, which I invariably do when it gets really bad), and here I am on the other side of my depression. Of course I know that it’s still early and perhaps it’s premature to declare victory, but I’m pretty in tune with how my illness (at least the Alpha pathology, depression) functions and I feel fairly safe saying that tianeptine works for me. My biggest problem has not been that I don’t respond to medication but rather that I can’t get or afford the medication I need. Happy to answer any questions if I can. Good luck everyone!
Posted by Phillipa on August 30, 2007, at 21:21:48
In reply to Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on August 30, 2007, at 21:10:36
Well I'm certainly happy for you that your med is working. Can you continue not to self sabotage yourself do you think? Phillipa
Posted by Dragon Black on August 30, 2007, at 21:36:20
In reply to Re: Tianeptine appears to work. Now fix my brain! » Dragon Black, posted by Phillipa on August 30, 2007, at 21:21:48
> Well I'm certainly happy for you that your med is working. Can you continue not to self sabotage yourself do you think? Phillipa
I think so. When I'm normal (not depressed) I tend to eat well, exercise, and generally flourish. The thing that proved a major problem in the past was anxiety, which I wasn't treating b/c I hadn't diagnosed it (nor had numerous doctors, to their collective shame, despite numerous clear warning signs that would have tipped off a first year med student) and I just chalked up all the residual problems to depression b/c in my mind THAT was what was wrong with me. Didn't notice the glaring co-morbid GAD. But I'm onto him this time. That's one of reasons I chose tianeptine.
Posted by Dragon Black on August 30, 2007, at 21:42:04
In reply to Re: Tianeptine appears to work. Now fix my brain! » Dragon Black, posted by Phillipa on August 30, 2007, at 21:21:48
> Well I'm certainly happy for you that your med is working. Can you continue not to self sabotage yourself do you think? Phillipa
not that it really matters, but to describe my behavior as self-sabatoge, while in a sense true, is misleading and unfair. it may be an unhappy consequence of such behavior, but it isn't what I'm doing in asmuch as it is in no way tied to intent. What I'm/was doing is self-medicating, plain and simple.
Posted by Phillipa on August 30, 2007, at 21:46:44
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on August 30, 2007, at 21:42:04
So now your doc is prescribing the med for you? Phillipa
Posted by Dragon Black on August 30, 2007, at 22:17:16
In reply to Re: Tianeptine appears to work. Now fix my brain! » Dragon Black, posted by Phillipa on August 30, 2007, at 21:46:44
nope. no health insurance, no money for doctors or the designer drugs they might prescribe me. i've decided to treat myself. i've pretty much lost all faith in the american medical establishment anyway, and i think i can do a better job on my own and without their interference.
Posted by elanor roosevelt on September 2, 2007, at 22:29:37
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on August 30, 2007, at 22:17:16
tianeptine seems to be the solution for a lot of people who have run out of options
too bad the pdocs are not more open about working with it
Posted by fuchsia on September 3, 2007, at 7:35:47
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by elanor roosevelt on September 2, 2007, at 22:29:37
Do you consider yourself bipolar?
I have bipolar and will be trying tianeptine. It's interesting that you have had a 'minicycle'.
fuchsia
Posted by Dragon Black on September 3, 2007, at 16:00:18
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by fuchsia on September 3, 2007, at 7:35:47
> Do you consider yourself bipolar?
>
> I have bipolar and will be trying tianeptine. It's interesting that you have had a 'minicycle'.
>
> fuchsia
>Years ago I considered whether I was bipolar and finally decided that I wasn't, just MDD. My brother is (schizo-affective, actually) and my mother and one of my sisters have both been diagnosed with bipolar. However, I've always thought that both were incorrect, and a Pdoc actually retracted the Dx for my sister. My mother tends to present as just a classic unipolar. Lately, however, I've begun to reassess whether I do in fact fall into the BPII spectrum. I do minicycle into and out of depression (several times over the course of 7-10 days or so) and I tend to be hypomanic when I come out of them. I've always thought that this wasn't true mania but rather represented the enormous relief that attends leaving a depressive episode. Of course I feel hypo - it's the "return of hope" - especially when I've been on the brink and feel that things needed to get better or else, I think that it would be impossible to come out of it and just be euthymic. Within a week or two I get habituated to feeling normal again and usually am no longer hypomanic. But ultimately I don't really know, I'm aware that I have a strong psychic bias against escalating the label I wear, and I definitely have times where I fit a lot of the symptoms of hypomania. Still trying to wrap my head around it. I also have conflicted thoughts about the validity of the entire categories of BPII, cyclothymia, etc. I mean, at some point, it's like the sphere of behavior being encompassed covers pretty much everyone....
Posted by fuchsia on September 3, 2007, at 19:07:02
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on September 3, 2007, at 16:00:18
Hello
My diagnosis is BPII and I have to say you sound like me; especially with that sudden bouncing out of depression. Like you I felt the hypomania was the relief at being undepressed; what a stroke of luck, I am better now, I won't waste anymore time getting back to things. Now I think that was too sudden for it to have been unipolar. I took years for me to accept the diagnosis because I didn't want to think that I had such a serious illness.
Really, it does seem quite a phenomenon to me, bouncing out of depression like that; like flowers blooming in the desert. I don't know how severe your depression is. The fact that mine is very severe is why it seems so spectacular to me.
The 'nestling back into the dungeon' feels like me too.
fuchsia
> > Do you consider yourself bipolar?
> >
> > I have bipolar and will be trying tianeptine. It's interesting that you have had a 'minicycle'.
> >
> > fuchsia
> >
>
> Years ago I considered whether I was bipolar and finally decided that I wasn't, just MDD. My brother is (schizo-affective, actually) and my mother and one of my sisters have both been diagnosed with bipolar. However, I've always thought that both were incorrect, and a Pdoc actually retracted the Dx for my sister. My mother tends to present as just a classic unipolar. Lately, however, I've begun to reassess whether I do in fact fall into the BPII spectrum. I do minicycle into and out of depression (several times over the course of 7-10 days or so) and I tend to be hypomanic when I come out of them. I've always thought that this wasn't true mania but rather represented the enormous relief that attends leaving a depressive episode. Of course I feel hypo - it's the "return of hope" - especially when I've been on the brink and feel that things needed to get better or else, I think that it would be impossible to come out of it and just be euthymic. Within a week or two I get habituated to feeling normal again and usually am no longer hypomanic. But ultimately I don't really know, I'm aware that I have a strong psychic bias against escalating the label I wear, and I definitely have times where I fit a lot of the symptoms of hypomania. Still trying to wrap my head around it. I also have conflicted thoughts about the validity of the entire categories of BPII, cyclothymia, etc. I mean, at some point, it's like the sphere of behavior being encompassed covers pretty much everyone....
Posted by Dragon Black on September 3, 2007, at 21:21:25
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by elanor roosevelt on September 2, 2007, at 22:29:37
tianeptine is quite the black eye for western medicine, kind of undermines the last 60 years of theory and practice. not a medication that will be welcomed in the states, that's for sure.
> tianeptine seems to be the solution for a lot of people who have run out of options
>
> too bad the pdocs are not more open about working with it
>
>
Posted by Dragon Black on September 4, 2007, at 13:47:41
In reply to Re: Tianeptine appears to work. Now fix my brain! » Dragon Black, posted by fuchsia on September 3, 2007, at 19:07:02
Is entering and leaving a depressive episode the way I do really such a tell for BP? Can't regular old unipolars do this?
> Hello
>
> My diagnosis is BPII and I have to say you sound like me; especially with that sudden bouncing out of depression. Like you I felt the hypomania was the relief at being undepressed; what a stroke of luck, I am better now, I won't waste anymore time getting back to things. Now I think that was too sudden for it to have been unipolar. I took years for me to accept the diagnosis because I didn't want to think that I had such a serious illness.
>
> Really, it does seem quite a phenomenon to me, bouncing out of depression like that; like flowers blooming in the desert. I don't know how severe your depression is. The fact that mine is very severe is why it seems so spectacular to me.
>
> The 'nestling back into the dungeon' feels like me too.
>
> fuchsia
>
>
> > > Do you consider yourself bipolar?
> > >
> > > I have bipolar and will be trying tianeptine. It's interesting that you have had a 'minicycle'.
> > >
> > > fuchsia
> > >
> >
> > Years ago I considered whether I was bipolar and finally decided that I wasn't, just MDD. My brother is (schizo-affective, actually) and my mother and one of my sisters have both been diagnosed with bipolar. However, I've always thought that both were incorrect, and a Pdoc actually retracted the Dx for my sister. My mother tends to present as just a classic unipolar. Lately, however, I've begun to reassess whether I do in fact fall into the BPII spectrum. I do minicycle into and out of depression (several times over the course of 7-10 days or so) and I tend to be hypomanic when I come out of them. I've always thought that this wasn't true mania but rather represented the enormous relief that attends leaving a depressive episode. Of course I feel hypo - it's the "return of hope" - especially when I've been on the brink and feel that things needed to get better or else, I think that it would be impossible to come out of it and just be euthymic. Within a week or two I get habituated to feeling normal again and usually am no longer hypomanic. But ultimately I don't really know, I'm aware that I have a strong psychic bias against escalating the label I wear, and I definitely have times where I fit a lot of the symptoms of hypomania. Still trying to wrap my head around it. I also have conflicted thoughts about the validity of the entire categories of BPII, cyclothymia, etc. I mean, at some point, it's like the sphere of behavior being encompassed covers pretty much everyone....
>
>
Posted by brooke484 on September 4, 2007, at 20:57:45
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on September 3, 2007, at 21:21:25
Why won't it be approved here? Just curious...
Posted by fuchsia on September 5, 2007, at 6:07:06
In reply to Re: Tianeptine appears to work. Now fix my brain!, posted by Dragon Black on September 4, 2007, at 13:47:41
> Is entering and leaving a depressive episode the way I do really such a tell for BP? Can't regular old unipolars do this?
I think it is suggestive of BP. The unipolars I talk to don't seem to have the depression blinking on and off so arbitrarily and so suddenly.
fuchsia
Posted by Dragon Black on September 6, 2007, at 23:05:22
In reply to Re: Tianeptine appears to work - Dragon Black, posted by brooke484 on September 4, 2007, at 20:57:45
Honestly, I don't know. I've read a bunch of stuff but most appeared to be just speculation. Issues with patent expiration, etc., such that the enormous profit potential just wasn't there to incent one of the Pharms to pursue it in the states. I've also heard that it was shelved here to make way for fluoxetine (so way back), but I don't know anything about this. I've also heard sort of a general conspiracy theory that since tianeptine works opposite the SSRIs, the front line treatment for depression in the states for the last several decades, that there is enormous inter-institutional pressure and opposition to make sure it never shows up on these shores. This line of thinking holds that not only would it cut into the profits generated by other ADs, but that it would undermine the legitimacy of Psychiatry such that all ADs, maybe even all pharmaceuticals, would take a hit, the upshot being to the consumer, "wow, they really don't know what the hell causes these disorders or symptoms and they will just sell us anything." When one considers the recent scholarship on the parallel efficacy of placebo to ADs, not to mention the unbelievably enormous amounts of money at stake, one doesn't have a hard time believing that such a threat would be vigorously opposed behind the scenes.
> Why won't it be approved here? Just curious...
Posted by brooke484 on September 7, 2007, at 13:40:28
In reply to Re: Tianeptine appears to work - Dragon Black, posted by Dragon Black on September 6, 2007, at 23:05:22
Well that's too bad if it's true. People like me need all the help we can get. The SSRI's didn't work and I'm still searching for something that does. Next week it's on to Marplan.
Thanks for your reply.
Posted by fuchsia on September 8, 2007, at 6:07:26
In reply to Re: Tianeptine appears to work - Dragon Black, posted by Dragon Black on September 6, 2007, at 23:05:22
Dragon Black
I presume the tianeptine is still going OK? Can you keep us up-dated please?
I started taking it yesterday. I've had a bit of mental fuzziness and some anxiety; more yesterday than today. It's unclear from anything I've read how long it will take to work, if it's going to. I really hope it does work.
fuchsia
Posted by Dragon Black on September 10, 2007, at 18:14:00
In reply to Re: Tianeptine appears to work - Dragon Black » Dragon Black, posted by fuchsia on September 8, 2007, at 6:07:26
> Dragon Black
>
> I presume the tianeptine is still going OK? Can you keep us up-dated please?
>
> I started taking it yesterday. I've had a bit of mental fuzziness and some anxiety; more yesterday than today. It's unclear from anything I've read how long it will take to work, if it's going to. I really hope it does work.
>
> fuchsiaSo far, so good. at first i had days where i could really feel the effects shortly after taking it. some people described it as alcohol in a pill, which doesn't really capture it, but it was pretty similar, though i didn't really feel impaired or anything. i also had one day, day 10, where i felt completely weird and couldn't figure out what was wrong with me. this has mostly passed and i don't notice anything when i take it now. i've dropped the dose, too, to 2 pills per day or 1 and 1/2 per day too, both to see what works best for me and because cost is an issue and i have to make these last as long as possible. also, when I started I was on 800 mg of SAM-e a day. I've tapered down to 200 and it hasn't been a problem, so I chalk this up to tianeptine too. Overall I've been doing okay with it, still lots of problems and such, but it definitely got me out of my depression. Btw, I am BPII, like you thought I might be. It's been a crazy week coming to this realization - may start a new thread detailing it. Do you use any mood stabilizers? Good luck with your trial - let us know how it's working for you : )
Posted by Dragon Black on September 10, 2007, at 18:16:21
In reply to Re: Tianeptine appears to work - Dragon Black » Dragon Black, posted by fuchsia on September 8, 2007, at 6:07:26
> Dragon Black
>
> I presume the tianeptine is still going OK? Can you keep us up-dated please?
>
> I started taking it yesterday. I've had a bit of mental fuzziness and some anxiety; more yesterday than today. It's unclear from anything I've read how long it will take to work, if it's going to. I really hope it does work.
>
> fuchsiaforgot to mention, I think this has helped my anxiety too. kinda like the volume has been turned down on my anxiety. I'm quite pleased.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.