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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by kavinsky99 on March 24, 2014, at 20:18:08
Decided to give this a try. My current cocktail is:
600mg lithium
2g fish oil
600mg tyrosine
500mg inositol like two days a week
400mg to 600mg Magnesium citrate
30mg zinc
1g calcium
25mg tianeptineEverything else works good and as expected, however, tianeptine has been a weird experience for me.
During the first days, in which I took only 3mg (cut the pill in 4), I felt as normal as I haven't been in years. No antidepressant effect, but more like a very strong mood stabilizer and anxiolytic with NO side effects. Then I increased the dosage, and got stuck in 25mg (2 pills) a day initially due to the strong constipation it was causing. Then, I noticed I was getting VERY sad. Like, abnormally sad. I have depression, but more of the anxiety/stress/anger and subsequent fatigue style. Never actually experience feelings of sadness and low >mental< motivation.However, I noticed sometimes tianeptine will make me very sad, other times it will make me very relaxed in a good way. Other times, specially when I don't time the dosages well and take the two pills in under 3 hours, I notice is gives quite a boost - like a dopamine surge -.
I get very strong sexual desire/quick orgasms, faster heartbeat, quicker thinking, more attention/learning capacity, sometimes very strong PHYSICAL anxiety with no mental effect: think all the symptoms of a panic attack: clammy hands, numb arms/fingers, racing heart, dry mouth, pain in back/neck/chest due ot muscle rigidty, etc., and sometimes the nervous stutter - but no racing thoughts, no fear feelings... nothing on the mind, just body. And I'm capable of feeling REALLY good for no good reason when this happens (intercalating with anxiety).But what bothers me, is the awful SADNESS accompanied of my usual bad memories that keep popping in my head. And also no motivation. It feels truly awful. Is this "real" depression? Is tianeptine paradoxically causing depression? I know im' not at the recommended dosage, but frankly I'm scared. It makes me too spacey, sad and outright irrational, I'm afraid of what I might do. I also seem to distance myself from my life and things too much, keep feeling like I need "to rest" and nothing really matters much (not in a depressed-dramatic way, but rather a comfortable I'll-just-lay-down-and-float-away-from-everything). This scares me, as it changes my willing mind, unlike any med.
Anyways, this is, in my opinion, a good medication. Low side effect profile compared to any other AD i've tried (most SRRIs, bupropion, Effexor, mirtazapine), fantastic anxiolytic effect (no sedation per se, though sometimes it causes spaceyness. Also, no memory impairment, which was the reason I stopped benzos), good mood stabilization (I feel balanced out: capable of a full range of emotions - unlike most psychiatric medications, that seem like an on/off switch for an specific way of feeling/functiining) and the has the possibility to recover from stress induced damage to my brain, finally regulating the brain thingies that control anxiety and giving back my cognition.
In lower doses it was good, don't know if I'll get the same effect. I might try taking 3mg in the morning, 3mg in the afternoon and 3mg at night. Or do you think I should increase to the recommended dosage of 3 pills a day (37,5mg) to see what happens?
Any input would be great.
Posted by doxogenic boy on March 25, 2014, at 15:09:22
In reply to My experience with tianeptine (Stablon), posted by kavinsky99 on March 24, 2014, at 20:18:08
> In lower doses it was good, don't know if I'll get the same effect. I might try taking 3mg in the morning, 3mg in the afternoon and 3mg at night. Or do you think I should increase to the recommended dosage of 3 pills a day (37,5mg) to see what happens?
Since it works, I would have continued with low doses. I use 50 mg tianeptine (Tianeurax - generic tianeptine) six times a day (300 mg daily, see my signature below) with good results, but everyone is different. Maybe your combination interact with tianeptine differently than my combination.- doxogenic
Posted by ed_uk2010 on March 25, 2014, at 16:46:23
In reply to Re: My experience with tianeptine (Stablon), posted by doxogenic boy on March 25, 2014, at 15:09:22
Doxogenic,
Have you had an ECG (EKG) on that combination? Your meds put you at risk of arrhythmias due to prolonged QT interval, mainly due to the very high dose of escitalopram combined with a tricyclic.
Posted by doxogenic boy on March 25, 2014, at 16:51:56
In reply to Re: My experience with tianeptine (Stablon) » doxogenic boy, posted by ed_uk2010 on March 25, 2014, at 16:46:23
> Doxogenic,
>
> Have you had an ECG (EKG) on that combination?I think it is some years ago I have had ECG.
> Your meds put you at risk of arrhythmias due to prolonged QT interval, mainly due to the very high dose of escitalopram combined with a tricyclic.
Thanks for your concern. I will ask my psychiatrist about this tomorrow. Am I at a high risk?
- doxogenic
Posted by kavinsky99 on March 25, 2014, at 22:11:49
In reply to Re: My experience with tianeptine (Stablon), posted by doxogenic boy on March 25, 2014, at 16:51:56
> > Doxogenic,
> >
> > Have you had an ECG (EKG) on that combination?
>
> I think it is some years ago I have had ECG.
>
> > Your meds put you at risk of arrhythmias due to prolonged QT interval, mainly due to the very high dose of escitalopram combined with a tricyclic.
>
> Thanks for your concern. I will ask my psychiatrist about this tomorrow. Am I at a high risk?
>
>
> - doxogenicI agree, you're going too far regarding meds that mess with your heart.
Although, I've heard anedoctal reports of people that don't suffer any alteration on the QT interval from tryciclics or (es)citalopram.
Posted by uncouth on March 27, 2014, at 13:37:20
In reply to Re: My experience with tianeptine (Stablon), posted by doxogenic boy on March 25, 2014, at 15:09:22
Doxo--
I am very interested in hearing more about your experience with TIaneptine--especially how you got to such a high dose! I am quite interested in this medication and have a stock of it, though am currently trying Nardil. What do you take it for, and what effect does it have on you that you can discern...and how did you come to such a high dose? Did your doctor suggest it based on his experience, or was 37.5 simply ineffective.
I have heard that it becomes very stimulating at higher doses but do not have experience myself.
Any details you can share on your exp. with tianeptine would be appreciated.
Posted by doxogenic boy on March 27, 2014, at 19:44:10
In reply to Re: My experience with tianeptine (Stablon), posted by uncouth on March 27, 2014, at 13:37:20
> Doxo--
>
> I am very interested in hearing more about your experience with TIaneptine--especially how you got to such a high dose! I am quite interested in this medication and have a stock of it, though am currently trying Nardil. What do you take it for, and what effect does it have on you that you can discern...and how did you come to such a high dose? Did your doctor suggest it based on his experience, or was 37.5 simply ineffective.The reason why I started using tianeptine in combination with SSRI/TCA is that I found a case report in a German journal, a patient who had treatment resistant depression, who reached remission with a combination of sertraline, amitriptyline, carbamazepine and tianeptine.
See the case report in this message:
http://www.dr-bob.org/babble/20140307/msgs/1062040.htmlI sent the case report to my psychiatrist, and he agreed to give tianeptine a try. 22th September 2008 I started with tianeptine, and I have used it continuosly since then. When I added tianeptine at this date, I already used 40 mg escitalopram, 100 mg trimipramine, 300 mg pregabalin, 600 mg quetiapine, 30 mg liothyronine and 1 mg clonazepam. (Later I stopped taking pregabalin and clonazepam, and added agomelatine.)
Here is my dose titration of tianeptine:
22 September 2008: 12,5 mg
23 September 2008: 37,5 mg
16 October 2008: 50 mg
19 January 2009: 75 mg
12 March 2009: 87,5 mg
13 March 2009: 100 mg
5 May 2009: 150 mg
25 October 2009: 300 mg (50 mg tianeptine six times a day)I found out that if I took 50 mg tianeptine in one dose, I felt calm and inner peace after about one hour. Later on I theorized that if I took 50 mg tianeptine every second hour, I would feel good all the time. I asked my psychiatrist if I could try this, and he agreed. It worked, so from late October 2009, my severe treatment resistant depression, which started in about August 2004, was gone! [I have been depressed before too, most of my life.] I thought of suicide and had extreme levels of anxiety all the time for those five years - a living hell - and all my anxiety disappeared when I started with 300 mg/day.
I my country, the welfare state gives me my medication nearly for free, so I get no financial problems for my combination of six meds.
> I have heard that it becomes very stimulating at higher doses but do not have experience myself.
For me this combination was not stimulating, just inner peace without sedation. The best thing is that it still works, after four and a half years! It probably had been different if I took 300 mg tianeptine monotherapy.
Here is my medication history. I started with meds in 1994:
http://www.dr-bob.org/babble/20090826/msgs/914853.html
http://www.dr-bob.org/babble/20130828/msgs/1050311.htmlI wonder how my coctail works neurobiologically, since tianeptine and escitalopram has the opposite effect? And maybe there exist other people out there with TRD who can benefit from my cocktail?
- doxogenic
Posted by doxogenic boy on March 27, 2014, at 19:51:07
In reply to Re: My experience with tianeptine (Stablon) » doxogenic boy, posted by ed_uk2010 on March 25, 2014, at 16:46:23
> Doxogenic,
>
> Have you had an ECG (EKG) on that combination? Your meds put you at risk of arrhythmias due to prolonged QT interval, mainly due to the very high dose of escitalopram combined with a tricyclic.Now, I have had ECG. I got an appointment immediately. The ECG showed normal results, so my psychiatrist recommended me to continue with the meds, with the same doses. Thank you very much for reminding me that I needed ECG.
- doxogenix
Posted by ed_uk2010 on March 28, 2014, at 9:32:50
In reply to Re: My experience with tianeptine (Stablon) » ed_uk2010, posted by doxogenic boy on March 27, 2014, at 19:51:07
> > Doxogenic,
> >
> > Have you had an ECG (EKG) on that combination? Your meds put you at risk of arrhythmias due to prolonged QT interval, mainly due to the very high dose of escitalopram combined with a tricyclic.
>
> Now, I have had ECG. I got an appointment immediately. The ECG showed normal results, so my psychiatrist recommended me to continue with the meds, with the same doses. Thank you very much for reminding me that I needed ECG.
>
> - doxogenixGood to hear! Glad you had it done.
Posted by kavinsky99 on April 4, 2014, at 7:17:26
In reply to Re: My experience with tianeptine (Stablon) » doxogenic boy, posted by ed_uk2010 on March 28, 2014, at 9:32:50
Very rarely I get the stimulant effect from taking a higher dose at once. I think tolerance builds up on that. The analgesic effects somewhat go away too... I get the same effect doxo gets, inner peace. I feel leveled but with a normal range of emotions.
I think most people with depression (I hipothesize specially those on the anxiety spectrum) could benefit greatly from blocking the glutamate receptors. I've tried a lot of serotonin, norepinephrine, dopamine and calcium channel blockers. Though they all work for their own thing, nothing really beat anxiety, most of my symptoms, bad feelings and mental inabilities as my current regimen that aims for NMDA blocking.
Tianeptine supposedly acts on the glutamate receptors in a number of ways.I think tianeptine is an absolutely fantastic drug, I wouls definetely give it a try. For me, it is more of a downer. Makes me a little sad and lazy. Some people do get the stimulation though.
Posted by BCFORME on July 22, 2017, at 21:37:01
In reply to Re: My experience with tianeptine (Stablon), posted by doxogenic boy on March 25, 2014, at 15:09:22
Doxogenic Boy, jeg har mistet min Google konto og ved ikke hvad jeg skal goere. Jeg vil noedig miste kontakt med dig. Nu har jeg skiftet navn her paa psychobabble saa den er forbundet med an anden mail adresse. Kan du proeve at sende mig en babblemail saa jeg kan se om det virker? Aargh! Jeg hader min computer! Guy/BCFORME
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