Posted by sukarno on March 8, 2006, at 6:14:59
In reply to Re: 1 year on tianeptine (Stablon) » sukarno, posted by ed_uk on March 7, 2006, at 15:55:19
"How's the diazepam taper going? Sounds like a sensible taper to me. Too often people try to withdraw overnight. This is very bad news!"
Hi Ed! :-) How are you doing? What is your medication regimen now? Are you still taking citalopram?
You are right about that. People taper much too quickly and this is probably part of the reason why benzodiazepines have such a bad name today, in addition to the irresponsible prescription of the 1970s.
I do feel slightly more nervous and was hyperventilating a bit last night, so I'm wondering if there is some relapse (not rebound) of my panic disorder.
I've been on 3 tablets a day of tianeptine for about 10 days and I really wish I could take 4 because I think this dose is subtherapeutic. Perhaps 13mg of diazepam per day is also not enough. My psychiatrist wanted me on a slightly higher dose of diazepam temporarily but I told him I was determined to taper. I think his idea was better... I really could be below the threshold needed to control panic attacks.
I know that back in 1995 I was on only 2mg diazepam 3 or 4 times a day and it was not enough to control the panic attacks. 18mg/day used to be the "magic number" which kept me 100% panic free, but I hope to take the minimum that is necessary to control the anxiety.
It seems my pdoc is more anti-Stablon than anti-diazepam. Seems he has no problem with diazepam. We are both in agreement over our dislike of alprazolam due to its short-acting nature and ability to actually precipitate anxiety.
He even told me to smoke 1 to 3 cigarettes per day if I thought that would help me with my motivation, since the drugs which helped my motivation (conventional TCAs) were intolerable in terms of side effects.
Smoking is such an unorthodox suggestion and I have not tried it (I'm a former smoker) again, but I had told him that nicotine was very effective at helping my motivation. It really works wonders and it is unfortunate that I cannot get prescription nicotine here. No gum or patches available whatsoever.
I guess I could ask him about pramipexole or ropinirole but don't they cause narcolepsy (sudden attacks of sleep which are uncontrollable)?
My goal is to discontinue diazepam someday and rely on Stablon to control anxiety as I feel, despite Stablon's psychological dependence, there is little or no physical dependence.
I'm afraid that benzodiazepines will become more tightly scheduled in the future and thus, I'd better consider abandoning them before this happens.
Seems like my pdoc would rather have me take diazepam and mirtazapine (Remeron) rather than Stablon. Have you tried Remeron? I wonder how a drug which is a serotonin _antagonist_ can help depression? Does dopamine production increase when you decrease serotonin?
Take care Ed! :-)