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5 months on tianeptine

Posted by pandey_m on May 9, 1999, at 20:09:00

In reply to Re: Started tianeptine, feeling hopefull, posted by George O. on May 7, 1999, at 1:12:28

I have been taking tianeptine for 5 months now.
Seems to be a very promising AD, but ... [the rest of this is about the "but"] no one really knows how to decide dosage, ("37.5mg a day for everyone" is nonsense) and not much is known about drug interactions. Side effect profile is very good. I am giving my experiences interspersed with my specific medical situation
because in newsgroups etc people incl me often forget that people will react differently on the same medication, even with identical diagnoses.

0. I started 12.5mg 3 times a day before meals for one month. I now take 7.25mg (=1/2 tab) twice a day with better response. One of the things that makes tian. work is that it reduces cortisol. It makes sense to decide dosage based on your pre-tianeptine-therapy plasma cortsol level, but where would you get a doc who would do this, except in France - and it would take some finding there too.

1. Tianeptine interacts with benzodiazepines which reduce its efficiency drastically - personal experience confirmed by journal info (cant remember source).
ditto for Zopiclone - personal exper. + the information sheet that comes with zopiclone out here says its "pharmacokinetics are similar to that of the benzodiazepines".

Insomnia is one of the listed possible side effects of amineptine (again, official info fr the manufacturer Servier) - I have sleep problems anyway, so I don't know ... if you are lucky you wont get insomnia with tianeptine.

Earlier today my shrink suggested trying small-dose Phenergan (promethazine 10mg) for sleep.
Tonight I'll give it a try.

2. Combines well with Amineptine. It is nowhere documented, but I feel tian. is a good antimanic too. (I am cyclothymic [swing from hypomania to moderate depression]) and want to avoid zombifying effects of lithium and conventional ADs. I have been trying out various ADs over the last 6 years before deciding on mood stabilisers. Amineptine and Tianeptine are the most promising in my experience).

3. Perhaps some research is required to assess efficacy of tianeptine + dynamic psychotherapy. I get (with tian.) dreams of long forgotten (upto 30-year old) negative experiences - a sort of abreaction. (officially listed possible side-effect - nightmares - but my amineptine dreams though somewhat unpleasant are not nightmares.)

4. Works for me as excellent anti-panic medication
also, that does not interfere with cognitive functions - I can start writing a tricky 1000-line C program within 2 hours after a panic attack; with 1 tab (=12.5mg) tianeptine + 0.125mg alprazolam (xanax)- that is half a 0.25mg xanax tab.

For panic Ive got to take the xanax also because tian. causes this nervousness that is clearly distinguishable from anxiety. [0.125mg i titrated after various trials)

Before I know of tianep. - 8 months ago I had a major panic attack and my shrink gave clomipramine controlled it but I couldn't do anything for a month. (I am taking tianep. under his "supervision", not suggestion)

5. For the 1st month I tried the standard regimen - 3 tabs a day, with no other medication. The nervousness become a problem. Then I added benzos which I recently found was a mistake. (I was dependent on 10mg/day Ativan from 1986-1993 - people who didnt have had such huge benzo dependency problems may find that benzos dont interfere THAT much with their tian.)

(While on that topic, I smoke 40-50 hand-rolled cigarettes a day.)

6. Officially (from the info that comes with the tianeptine box out here - this should not but may differ from country to country) the manufacturers Servier currently say -"Theraputic indications - Endogenous, neurotic and reactive depression, anxiodepressive states with gastrointestinal contents in particular and anxiodepressive states in alcoholics during withdrawal." I like the coyness of this company! They do the reverse of hyping their products.

I find it good for the blues after snorting Ritalin also, which I occasionally do while developing software or playing bridge.

Amineptine [survector] has one problem - if you crush it real fine and snort, it becomes habit-forming rather fast. Tianep. could be an excellent treatment for that. (I went on that binge for 10 days, started 1 tab (100mg) escalated to 15 tabs, got worried and stopped cold turkey - plunge into depression - took 2 tabs tian. at a time, slept(!), took 2 more after 10 hours, and by next day I was fine! (I stayed off Amineptine [and Ritalin, dexedrine, methedrine and cocaine] for a month without problems.)

7. With me, it combines well (as an AD improving intellectual functions) with the following in moderation - ginkgo, piracetam. Also works well with cannabis (in moderation) for enhancing esthetic/sensual experiences.

8. By itself tianeptine is not habit-forming; it is not that sort of molecule.

Conclusions - very promising, even for bipolar depression, but not yet a panacea for depression.
Tianeptine+Amineptine+abreaction therapy needs researching into, imho.

I (38 years old, male, cyclothymic depression; two depersonalization episodes) have completed 13 months on amineptine (7 months), tianeptine (1 month) or a combination of the two(5 months; presently 12.5mg tian.+100mg amin./day) with no hypomanic episodes; no depressive episodes except those induced by psychotropic experiments; amin. brought back my chess and bridge playing ability which 4 years of SSRIs had taken away, tian. further improved those and depth of feeling - but tian.-induced nervousness forces me to take at least some amount of benzos - otherwise
tian. alone actually makes me less sociable.
Also neither amin. nor tian. address hyperfocusing
(which is sometimes confused with obsessional thoughts, but in fact is "micromania").

I find it good; unipolar depressives and non-smokers might find it even better (with the caveat at the beginning).

That's all.




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