![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 58. Go back in thread:
Posted by floatingbridge on October 21, 2010, at 1:13:55
In reply to Re: Stablon (tianeptine), posted by SLS on October 20, 2010, at 5:29:21
> Crossed-fingers, well wishes, and prayers for me are welcome.
>
> :-)
>
>
> - ScottAll of the above on their way with more to come :)
Posted by Bob on October 21, 2010, at 1:20:44
In reply to Re: Stablon (tianeptine), posted by SLS on October 20, 2010, at 5:29:21
> > Yes Scott, I remember reading a post where you were having problems with Parnate. I am interested to hear what is working for you at the moment.
>
> I added agomelatine (Valdoxan) to my regime. The antidepressant effect is currently mild at best. However, it is early. I have been taking agomelatine for only 10 days. I wouldn't want to guarantee what it is about this drug that allows it to exert an antidepressant effect. For now, it seems that melatonin M1 and M2 receptor stimulation and serotonin 5-HT2c blockade are both important as per elegantly designed studies.
>
> I would like to give things another 2-4 weeks to measure the degree and persistence of the treatment adjustment. I am currently taking 25mg. As per the manufacturer's instructions, I will raise the dosage to 50mg after 2 weeks should the improvement plateau or wane.
>
> Current treatment regime:
>
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 200mg
> agomelatine 25mg
>
> It turns out that the only other person I know of for whom agomelatine is producing a robust therapeutic response is also taking Nardil 90mg.
>
> I have been losing sleep because of the sleep disruptions agomelatine is known to produce early in treatment. I have been moderately sleep deprived for a few days. It is possible that this is what is responsible for the mild improvement I am now experiencing. For some people, sleep deprivation can induce a transient antidepressant effect. It can even precipitate mania in certain individuals.
>
> I am cautiously optimistic. If the current improvement persists for longer than 3 days, I will become less cautious in my optimism.
>
> Crossed-fingers, well wishes, and prayers for me are welcome.
>
> :-)
>
>
> - Scott
>
I'm pullin' for you and everyone else on this board. I'd love to hear about a novel drug like Valdoxan making a difference. Please keep us apprised.- Bob
Posted by sigismund on October 21, 2010, at 2:09:50
In reply to Re: Agomelatine » sigismund, posted by SLS on October 20, 2010, at 14:54:02
>How would you describe the quality of your therapeutic response to agomelatine? Are you still taking it? Is 12.5mg as effective for you as 25mg?
My guess, Scott, is that ago will only be a little useful to you and that it might make sense to restrict your hopes to some improvement in sleep and a bit of dopaminergic push.
My response has changed over time. I have taken it for a year or two in doses that have ranged from 12.5mg/d to 50mg/d.
The initial response was impressive, by which I mean that I liked it and other people remarked that I was looking better.
Sleep was greatly improved......I slept normally.So what happened? (I mean with the sleep).
I don't know. I have a theory that my consumption of baicall skullcap (which I need for allergies) inhibits the enzyme which metabolises ago leading to higher concentrations of it, leading to tolerance of some of the effects, leading to bad sleep again. I still feel the dopaminergic thing.I'm currently on 25mg.
12.5 would not be as effective but it would not be a problem lowering it.
There seems to be little or no discontinuation syndrome.I don't have much experience with ADs. Only a little Parnate, tianeptine, agomelatine and the alternative things. If things got bad for me I'd try Nardil.
It's pathetic we know so little about sleep, and a pity the options are not better.
I went to ask a patient to look at Trazodone (some libido or more likely capacity wouldn't hurt) but it sounded so weird and awful I wasn't keen to try it.
Posted by sigismund on October 21, 2010, at 2:16:26
In reply to Re: Agomelatine » SLS, posted by sigismund on October 21, 2010, at 2:09:50
> other people remarked that I was looking better.
because I was much calmer.
But that is not a case of more is better, at least not in the first few months.
I found that 25mg/d (as opposed to 12.5 or 2/3 of a tablet) initially gave me a bad feeling, in the afternoons especially. It was different to normal anxiety. It seems in retrospect to be a good idea to let ones body find its own level.............I would have been better to have stayed longer at 12.5mg/d.
Posted by floatingbridge on October 21, 2010, at 2:29:46
In reply to Stablon (tianeptine), posted by twinleaf on October 18, 2010, at 22:10:18
Twinleaf, I'm behind the beat here, I guess, but stablon in any form is unobtainable in the us? Is this true?
Oh arrrgh.
Posted by SLS on October 21, 2010, at 2:56:42
In reply to Re: Agomelatine » SLS, posted by sigismund on October 21, 2010, at 2:09:50
> >How would you describe the quality of your therapeutic response to agomelatine? Are you still taking it? Is 12.5mg as effective for you as 25mg?
>
> My guess, Scott, is that ago will only be a little useful to you and that it might make sense to restrict your hopes to some improvement in sleep and a bit of dopaminergic push.That sounds about right. I am already experiencing diminishing returns. Of course, I'm hoping that it is a temporary worsening.
> The initial response was impressive, by which I mean that I liked it and other people remarked that I was looking better.> Sleep was greatly improved......I slept normally.
If for some reason you need to discontinue agomelatine, but would still like the sleep-enhancing effects of a melatonin M1/M2 agonist, you could opt for ramelteon (Rozerem). Of course, you may not glean an antidepressant effect from it.
Thanks for taking the time to respond. Very useful info.
Be well.
- Scott
Posted by twinleaf on October 21, 2010, at 7:06:48
In reply to Re: Stablon (tianeptine) » twinleaf, posted by floatingbridge on October 21, 2010, at 2:29:46
That's true. It is made by the French company Servier and can be legally purchased online. Psychiatrists can provide a prescription for it for you to enclose
Posted by floatingbridge on October 21, 2010, at 9:13:29
In reply to Re: Stablon (tianeptine) » floatingbridge, posted by twinleaf on October 21, 2010, at 7:06:48
Posted by Ernie D. on October 21, 2010, at 15:32:03
In reply to Stablon (tianeptine), posted by twinleaf on October 18, 2010, at 22:10:18
I trial Stablon for 4 weeks at 12.5mg/ 3x day and then an additional 2 weeks at 25mg / 3x day. No side effects-no benefits. I found it to be a sugar pill. I have now been taking 12.5mg of Agomelatine for a bout 9 months - not sure if it does anyting. Also trialed Trivastal for 3 weeks -found that to be a sugar pill as well. I think meds made by Servier tend to be very mild.
Posted by floatingbridge on October 21, 2010, at 17:00:09
In reply to Re: Stablon (tianeptine), posted by Ernie D. on October 21, 2010, at 15:32:03
Are agomelatine and stablon in the same category?
Sounds like they aren't quite enough for you, Ernie. Are you formulating a new med combo?
Posted by g_g_g_unit on October 22, 2010, at 3:48:30
In reply to Re: Stablon (tianeptine) » twinleaf, posted by floatingbridge on October 21, 2010, at 17:00:34
> Twinleaf, I'm behind the beat here, I guess, but stablon in any form is unobtainable in the us? Is this true?
>
> Oh arrrgh.
>
>floatingbridge... I'm (kinda) in a similar boat to you, i.e. ADD, major depression and also some PTSD-like symptoms. I found neurontin helped to control the weird 24-hour-long surges of adrenaline that hit me when we immigrated recently, but I was also sleeping 12 hours a day and constantly sedated.
I'm not in the US, so can't advise you on obtaining it legally, but I've just ordered a month's worth of Stablon to trial after being interested in the drug for the past 3 years. I'll let you know if it's useful for any of my ailments.
Posted by floatingbridge on October 22, 2010, at 12:42:41
In reply to Re: Stablon (tianeptine) » twinleaf, posted by floatingbridge on October 21, 2010, at 17:00:34
> Twinleaf, I'm behind the beat here, I guess, but stablon in any form is unobtainable in the us? Is this true?
>
> Oh arrrgh.
>
>Opppps.
Posted by floatingbridge on October 22, 2010, at 12:45:58
In reply to Re: Stablon (tianeptine) » floatingbridge, posted by g_g_g_unit on October 22, 2010, at 3:48:30
g_g_g, that would be great. And I know I'm not the only one who's curious. I hope it works well for you. Thanks :)
>
> floatingbridge... I'm (kinda) in a similar boat to you, i.e. ADD, major depression and also some PTSD-like symptoms. I found neurontin helped to control the weird 24-hour-long surges of adrenaline that hit me when we immigrated recently, but I was also sleeping 12 hours a day and constantly sedated.
>
> I'm not in the US, so can't advise you on obtaining it legally, but I've just ordered a month's worth of Stablon to trial after being interested in the drug for the past 3 years. I'll let you know if it's useful for any of my ailments.
>
>
Posted by sigismund on October 22, 2010, at 22:28:04
In reply to Re: Stablon (tianeptine), posted by floatingbridge on October 21, 2010, at 17:00:09
I took tianeptine for a year or two.
It made me feel a bit nice.
Later it tended to make me anxious. Then I stopped over a period of time.
Tianeptine and agomelatine have a somewhat similar feel and side effect profile (for me). Neither has much of a discontinuation syndrome.
Posted by sigismund on October 22, 2010, at 22:32:02
In reply to Re: Stablon (tianeptine), posted by Ernie D. on October 21, 2010, at 15:32:03
>Also trialed Trivastal for 3 weeks -found that to be a sugar pill as well.
I liked that one too :)
>I think meds made by Servier tend to be very mild.
Could be. Seem pretty tolerable.
Posted by Ernie D. on October 23, 2010, at 22:30:45
In reply to Re: Stablon (tianeptine), posted by floatingbridge on October 21, 2010, at 17:00:09
> Are agomelatine and stablon in the same category?
>
> Sounds like they aren't quite enough for you, Ernie. Are you formulating a new med combo?Survector is the best med ever developed by Servier. Unfortunately there is only one source left to obtain it. I have also tried the Russian Afobazol but found it to be a sugar pill as well.
I have a supply of Adaptol(Mebicar) but have not tried it yet because I have not seen many user posts about its effectiveness.
Posted by maxime on October 29, 2010, at 16:32:54
In reply to Re: Stablon (tianeptine), posted by SLS on October 20, 2010, at 5:29:21
I'm praying for you. I hope it works.
Posted by SLS on October 29, 2010, at 16:47:19
In reply to Re: Stablon (tianeptine) » SLS, posted by maxime on October 29, 2010, at 16:32:54
> I'm praying for you. I hope it works.
Thanks, Maxime.
Unfortunately, the robust improvement that I experienced last week has disappeared. I have enough medication for another month, so I might as well stay the course. Who knows?
- Scott
Posted by floatingbridge on October 29, 2010, at 18:34:04
In reply to Re: Stablon (tianeptine) » maxime, posted by SLS on October 29, 2010, at 16:47:19
Hi Scott,
You were being a little quiet, I thought. I'm praying for you, too.
fb
Posted by Conundrum on October 29, 2010, at 21:30:04
In reply to Re: Stablon (tianeptine) » SLS, posted by floatingbridge on October 29, 2010, at 18:34:04
I just started this med. At first the pills tasted sweet and I thought, sh!t I hope they didn't send me placebos, so I bit it and it had that pharmaceutical bitterness to it. I hope it enhances sensation and emotional depth, I'm skeptical though.
Posted by twinleaf on October 29, 2010, at 21:33:43
In reply to Re: Stablon (tianeptine), posted by Conundrum on October 29, 2010, at 21:30:04
I don't know about enhancing, but there's no numbing or blunting - very welcome after years of SSRI's.
Posted by floatingbridge on October 29, 2010, at 22:27:44
In reply to Re: Stablon (tianeptine), posted by Conundrum on October 29, 2010, at 21:30:04
Conundrum, may I ask what symptoms you hope to address?
Posted by Conundrum on October 29, 2010, at 22:35:09
In reply to Re: Stablon (tianeptine) » Conundrum, posted by floatingbridge on October 29, 2010, at 22:27:44
I need to be able to feel normal emotions again. I don't get pleasure from normal things like I had in the past and the world seems colorless. For instance music doesn't really get me going like I used to and I barely play my guitar anymore. Sex doesn't even feel very good. I also seem to really lack confidence, maybe because of the cognitive issues?
I also have trouble with motivation which is probably tied in with the anhedonia. Memory improvement would be nice too.
So far the drugs that have helped the most are low dose prozac, mirtazapine, and pristiq.
Low dose prozac increases motivation and interest, but not pleasure. Mirtazapine is similar but was stronger, however it pooped out. Pristiq made the world seem a little more colorful and even increased sexual arousal, but the effect faded.
I've also found abilify helped to motivate me and then stopped. The most consistent drug is low dose prozac.
I think I may need some NRI action. Man I remember when I took pristiq the left side of my head was tingling, it was like a light switch went back on in my head.
Maybe I'm barking up the wrong tree with tianeptine and should be trying cymbalta or mixing an NRI with that low dose prozac.
Posted by floatingbridge on October 29, 2010, at 23:52:42
In reply to Re: Stablon (tianeptine) » floatingbridge, posted by Conundrum on October 29, 2010, at 22:35:09
Well, you'll find out soon. Wouldn't that be wonderful to have it work? I hope so. Is tianeptine long to take effect and to discontinue?
You've tried pristiq's older relative effexor?
I have only tried strattera, an nri, I believe. Not good for me, though :( but maybe for you. I realize your med
knowledge is far more extensive than mine.Anohedonia was brought about by prozac treatment? I'm sorry I've forgotten. Losing touch with music must be painful. I used to write.... :(
Posted by Conundrum on October 29, 2010, at 23:57:03
In reply to Re: Stablon (tianeptine) » Conundrum, posted by floatingbridge on October 29, 2010, at 23:52:42
Yeh it started after stopping prozac, but restarting at the time made me feel horrible. Now I can tolerate a very low dose and feel some motivation.
I've never tried effexor, but I'm curious about it.
I would think tianeptine would start working in a couple weeks, but I could be wrong about that.
I might do well on strattera but i think one of the things that made pristiq work is that it stays in you for 24 hours. I noticed the effects the next morning after my first dose. I didn't sleep the whole night but I could feel a difference the next day. I've tried ritalin which is a DNRI and it did not help with my symptoms.
Go forward in 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.