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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
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
Posted by maxime on November 3, 2010, at 21:20:42
In reply to Re: Should I tell my pdoc about stablon? » maxime, posted by Conundrum on November 3, 2010, at 20:27:25
I think it was good that you told her.
Have you taken Desipramine before? Does it really help you concentrate? Did you gain weight on it. I am thinking of asking my pdoc if I can add to my cocktail.
I hope the Stablon works for you.
Posted by maxime on November 3, 2010, at 21:23:52
In reply to Re: Should I tell my pdoc about stablon?, posted by Conundrum on November 3, 2010, at 21:02:11
I think it's too early to tell whether or not the med will. Don't get discouraged okay? Just give it some time. How long have you been taking it for now? Are you on the maxime dosage?
If it doesn't work, you can go back to your pdoc and get the desipramine. So you are not out of options yet. Relax and the med will have a better chance of working.
Hang in there, and post updates.
Posted by Conundrum on November 3, 2010, at 21:29:23
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by maxime on November 3, 2010, at 21:20:42
> I think it was good that you told her.
>
> Have you taken Desipramine before? Does it really help you concentrate? Did you gain weight on it. I am thinking of asking my pdoc if I can add to my cocktail.
>
> I hope the Stablon works for you.Actually I've never tried desipramine, but it SHOULD, heh, help with concentration. It is a norepinephrine reuptake inhibitor, which is what ADHD drugs like strattera, ritalin, adderall, and dexedrine do. It will also inhibit the reuptake of dopamine in the prefrontal cortex.
Of course this is what I'd like to take. I have no idea if she would prescribe it. If she had prescribed an SNRI or an MAOI I would have ben SOL, because they probably wouldn't be compatible with stablon, or hinder it from working properly.
The upside is that, if I started desipramine now, it might be hard to tell the effects of one drug from the other and that by giving stablon time on its own, I can determine its usefulness. I"m just not patient, and I am kind of skeptical of stablon, and feel fairly certain desipramine would have some effect, since pristiq an SNRI had some effect and remeron another noradrenergic drug had an effect.
Posted by Conundrum on November 3, 2010, at 21:36:36
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by maxime on November 3, 2010, at 21:23:52
Hey, I've only been on it for a few days, since Friday maybe. I was hoping it would work more like a stimulant and have an immediate effect. I know I'm not patient. Its bad. Generally meds seem to work fast for me and poop out or not work at all. Since this is a serotonergic med I guess I should give it at least a few weeks. I can increase remeron in the meantime. I know what remeron feels like when it kicks in, because it did when I started it at 30(then pooped out). If it doesn't kick in at 60 at least I will have trialed it at a high dose and won't wonder what would have happened if I tried it at that dose. I know its bad that I am not patient, but I think I respond fairly quickly to drugs. Like prozac starts kicking in for me before it reaches a steady state.
> I think it's too early to tell whether or not the med will. Don't get discouraged okay? Just give it some time. How long have you been taking it for now? Are you on the maxime dosage?
>
> If it doesn't work, you can go back to your pdoc and get the desipramine. So you are not out of options yet. Relax and the med will have a better chance of working.
>
> Hang in there, and post updates.
Posted by sukarno on November 4, 2010, at 3:44:35
In reply to Try taking ten Stablon pills, that'll give ya..., posted by Brainbeard on November 2, 2010, at 13:34:08
LOL! Definitely. I took two at once in the morning and then followed it with another an hour or two later and had the best buzz. Music sounded so clear and my body felt numbish (no pain), euphoric and a stimulant effect. There was effect on heartrate or rhythm though.
I felt like I wanted to hug everything and felt a lot of empathy.
Posted by sukarno on November 4, 2010, at 3:47:13
In reply to Re: Try taking ten Stablon pills, that'll give ya... » Brainbeard, posted by sukarno on November 4, 2010, at 3:44:35
no effect on heartrate or rhythm, I meant to say..
Posted by conundrum on November 4, 2010, at 14:22:35
In reply to Re: Try taking ten Stablon pills, that'll give ya... » Brainbeard, posted by sukarno on November 4, 2010, at 3:44:35
I took 3 at once over the weakend after taking 1 about an hour earlier. I felt nothing. I've taken 6x5mg methylphenidate and all I felt was a headache, increased heartrate and I started talking faster.
I feel so spacey right now. I think it might be the tianeptine, because there is a bit of the numbness. Maybe 3x a day is too much. I also increased from 30 mg remeron to 60 mg. I don't think its the remeron since I took 45mg before and didn't feel spacey.
> LOL! Definitely. I took two at once in the morning and then followed it with another an hour or two later and had the best buzz. Music sounded so clear and my body felt numbish (no pain), euphoric and a stimulant effect. There was effect on heartrate or rhythm though.
>
> I felt like I wanted to hug everything and felt a lot of empathy.
Posted by sukarno on November 4, 2010, at 14:43:31
In reply to Re: Try taking ten Stablon pills, that'll give ya... » sukarno, posted by conundrum on November 4, 2010, at 14:22:35
Sometimes though I must admit that taking multiple tablets of Stablon did nothing. I'm not sure why that is. I suppose it is such a complex drug.
Upon further research it appears that tianeptine hits the mu-opioid receptor when used in high doses such as 30 tablets at once as the Russian opiate addicts do when they run short of heroin. Then again, they shoot it up, which is nasty and sometimes results in necrosis and amputation of the limbs. It's under lock and key in many Russian pharmacies (known as Coaxil there).
I really do want to give tianeptine another try because my depression and anxiety are gradually getting worse. :-( It is a very expensive medication though...
Posted by Brainbeard on November 4, 2010, at 16:27:31
In reply to Re: Try taking ten Stablon pills, that'll give ya..., posted by sukarno on November 4, 2010, at 14:43:31
Posted by maxime on November 4, 2010, at 19:50:03
In reply to Re: Try taking ten Stablon pills, that'll give ya... » Brainbeard, posted by sukarno on November 4, 2010, at 3:44:35
> LOL! Definitely. I took two at once in the morning and then followed it with another an hour or two later and had the best buzz. Music sounded so clear and my body felt numbish (no pain), euphoric and a stimulant effect. There was effect on heartrate or rhythm though.
>
> I felt like I wanted to hug everything and felt a lot of empathy.Probably not the best idea to post this on PB. Advocating that people take more than they should is not responsible imho.
Posted by g_g_g_unit on November 5, 2010, at 2:46:56
In reply to Re: Should I tell my pdoc about stablon? » g_g_g_unit, posted by Conundrum on November 3, 2010, at 13:01:58
>
> I think you might like it, G Unit.
> >
>
>I hope so, though I'm beginning to think it may be too mild to help me with my anxiety. How does it compare to an SSRI in that respect? Do you notice any relief from anxiety/worry/obsessive thinking (if present)?
Posted by Conundrum on November 5, 2010, at 10:40:58
In reply to Re: Should I tell my pdoc about stablon? » Conundrum, posted by g_g_g_unit on November 5, 2010, at 2:46:56
It definitely makes you not worry. In fact I'd say its more of an anti-anxiety medication, than an antidepressant. Like I have this class and I was supposed to have picked a topic by Tuesday, but didn't until yesterday but it cost me some points. But I'm like who gives a f*ck? Prior to this week I was worried the course was too advanced, but now I take it more in stride.
Obsessive thinking? I'm not sure about that one. I only get like that about medications. I think it could help. People say that it boosts dopamine in the long term which could be bad for obsessive thinking.
>
> >
> > I think you might like it, G Unit.
> > >
> >
> >
>
> I hope so, though I'm beginning to think it may be too mild to help me with my anxiety. How does it compare to an SSRI in that respect? Do you notice any relief from anxiety/worry/obsessive thinking (if present)?
>
This is the end of the thread.
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