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Dr. Bob is Robert Hsiung, MD,
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Posted by sukarno on September 9, 2006, at 8:17:29
In reply to Re: Tianeptine tolerance, depression returns » sukarno, posted by ed_uk on July 9, 2005, at 11:42:54
Is there anyone else here on Stablon? I'm taking 12.5mg QID (4x/day) and am doing quite well. I take one tablet every 6 hours and that seems to have eliminated the "see-saw" effect. I do feel a consistent antidepressant effect. Reducing the dosage of Stablon to TID (3x/day) results in relapse of depression and anxiety.
I'm also on diazepam (Valium) 10mg BID and famotidine 40mg QID.
I tried lansoprazole (Prevacid) 15mg/day and it stopped the GERD too, but it also caused me to regurgitate quite frequently and sometimes at night (I would wake up almost choking on refluxate... can you choke to death if you regurgitate food at night while sleeping?).
I then had a high fever on day 10 of Prevacid treatment. Quitting resulted in the fever disappearing the following day. I quit Prevacid for one month and tried a rechallenge. Fever and bone pain returned on day 3.
(I read later that PPIs all readily convert into a sulfonamide after ingestion and I've read that people allergic to sulfa antibiotics also have allergies to PPIs.) I only had a fever on Prevacid, so could that be an allergy? It sure seems like some sort of immune response.
I'm not sure if it is a good idea to try another PPI if I'm hypersensitive to the sulfonamide. I hope I'm only sensitive to the parent drug.
It seems that in panic disorder, depression and GERD both coexist frequently. I'm trying to treat all three.Diazepam is an excellent medication for the anxiety, but it does have adverse effects on memory at times and persistent daytime drowsiness despite having taken it or other benzodiazepines for 16 years. I wish I could quit taking it, but it isn't easy. I haven't experienced any significant withdrawal symptoms from tapering the dose, but I did experience more panic attacks (I don't believe they were rebound attacks...it seemed to be the classic attacks that were returning when I had been on 12mg/day for at least two months. I had reduced tianeptine to 12.5mg 3x/day at that time, so that could have been another factor.)
Tianeptine works very well for reducing worrisome thoughts and other psychic tension. It also helps mildly to moderately for the depression. It would probably be a great adjunct to any anxiolytic regimen. I actually have S.A.D. and should use my lightbox, but taking tianeptine (Stablon) is easier and has other benefits such as helping my asthma.
I have read that tianeptine is efficacious in panic disorder, but I haven't been able to try it as monotherapy yet.I'm glad I toughed it out through those first weeks on Stablon because it has really paid off in the long term. :-) Definitely, in my experience, tianeptine is easier to tolerate than SSRIs or other tricyclic antidepressants and there are almost no side effects with extended use.
Taking it four times a day seems to be the right amount for me. I hope others can share their experiences with this medication.:-)
Posted by psychobot5000 on September 10, 2006, at 10:38:41
In reply to 18 months on tianeptine (Stablon), posted by sukarno on September 9, 2006, at 8:17:29
Hi,
I've been on tianeptine 12.5mg 3/day for...perhaps sixteen months, and it is the best med I've found so far, though it's not a complete fix.
I take it for anergic, anhedonic, asthenic depression. It elevates my mood as much as any medication (which is not enough to make me feel good, but at least brings me out of the horrible pits), without any significant side-effects. SSRIs, for example, were no better, but increased my anxiety, gave me awful stomach problems, prevented me from sleeping...etc etc.
Tianeptine eliminates my depression-related stomach troubles, and helps mildly with my anxiety, as well as elevating my mood. No increase in difficulty sleeping, no irrition, nothing like that, though I am still left without much motivation. I have tried many augmentors, but none seems to do much.
Tried 25mg 3/day for a couple weeks once, but it made me feel a little strange, and at that dose I got dry mouth. Wasn't able to convince myself that there was any additional mood benefit.
In sum, I wish its antidepressant effect were stronger, but it's effective in that regard, helps me breath a little better, helps with anxiety and irrational worrying, helps with my abdominal pain, helps with other random somatic pain (like many depressives, I suffer from increased pain-sensitivity--Tianeptine eliminates that), and has no significant side-effects. Upping the dose was not useful for me.
If you're dealing with depression, anxiety, and stomach issues, I'd recommend Remeron/mirtazapine. It was a good anxiolytic and antidepressant, but can be very sedating. It wasn't hard on the stomach, like many other meds can be (I hate SSRIs).
Have you tried ranitidine or famotidine for your GERD? They can be effective acid-reducers, but you have to be a little careful about interactions--they may effect liver enzymes and raise the levels of other meds. My doc, however, says that it's mostly their sister cimetidine that does that, and that ranitidine and famotidine are okay, as well as being effective against GERD.
For myself, I just wish Stablon had more effect on my lack of motivation and pleasure. It makes me more laid back and relaxed, but...I'm drive deficient.
Supplementing with stimulants or a dopaminergic (tianeptine does not seem to actually be very dopaminergic) seems like natural augmentation strategies for tianeptine. I have heard some people say they are effective.
Hope this is useful,
P-bot
Posted by Last Chance on September 10, 2006, at 11:06:29
In reply to 18 months on tianeptine (Stablon), posted by sukarno on September 9, 2006, at 8:17:29
Sukarno - maybe I quit too soon with the Tianeptine? I should have kept a journal, because I can't remember why I stopped - I know that I got headaches both times I tried, and I must have felt no benefit. The 2nd attempt I tried harder, a couple weeks. What were the side effects you encountered, and about how much time passed before you felt like it was working? I am still on half 6mg Emsam, and am feeling terrible lately - thinking of stopping, but not sure what withdrawal symptoms to expect - could not handle feeling any worse than right now.
Posted by sukarno on September 11, 2006, at 3:47:26
In reply to Re: 18 months on tianeptine (Stablon) » sukarno, posted by Last Chance on September 10, 2006, at 11:06:29
"Sukarno - maybe I quit too soon with the Tianeptine? I should have kept a journal, because I can't remember why I stopped - I know that I got headaches both times I tried, and I must have felt no benefit."
Hi there! :-) Yeah, I had a lot of headaches when I first started taking it. I wasn't sure if it was the Stablon or my computer monitor (which gave me eyestrain and headaches before I started Stablon). I think Stablon does cause some headaches at the beginning of treatment.
"The 2nd attempt I tried harder, a couple weeks. What were the side effects you encountered, and about how much time passed before you felt like it was working?"
I would try it again for about 4 to 8 weeks. It seems that tianeptine takes as long as any standard antidepressant to begin working. I don't think tianeptine works any faster than the other antidepressants. I felt the first effects 12 days into treatment, but the full anxiolytic and antidepressant effects took at least 6 weeks.
The first side effects were some headaches, nervousness (but nothing that would cause a panic attack), decreased appetite and partial insomnia. Those gradually disappeared and my mood was much better and I felt much more relaxed. Now I have no side effects except for an occasional mild dry mouth which only lasts a few hours when it does happen.
I hope you can give it another try. You can always lower the dose if you experience side effects and then increase it again after you stabilise for a while. I found that I need 4 tablets a day for it to work. Three tablets just wasn't enough to keep the depression at bay.
Good luck to you! I hope it all works out. Let me know if you start taking Stablon again. :-)
Cheers,
Sukarno
Posted by SLS on September 11, 2006, at 5:15:42
In reply to Re: 18 months on tianeptine (Stablon), posted by psychobot5000 on September 10, 2006, at 10:38:41
> I take it for anergic, anhedonic, asthenic depression. It elevates my mood as much as any medication (which is not enough to make me feel good, but at least brings me out of the horrible pits),
Have you thought to add Wellbutrin?
- Scott
Posted by psychobot5000 on September 11, 2006, at 9:40:56
In reply to Re: 18 months on tianeptine (Stablon) » psychobot5000, posted by SLS on September 11, 2006, at 5:15:42
Hmmmm
Never tried the two together--wellbutrin caused sleep difficulties, nervousness/irritability, and stomach trouble when I took it before.
But tianeptine is beneficial enough for nerves and anxiety, that wellbutrin, or something like it, might work out. Not a bad idea. ...It's worth mentioning, that methylphenidate used to make me uncomfortable anxious, but that it's more pleasant when used as an augmentor to tianeptine.
May try the Rhodiola next (seems as though it has some reasonably powerful stimulant effects).
Posted by Declan on September 11, 2006, at 15:13:16
In reply to Re: 18 months on tianeptine (Stablon), posted by psychobot5000 on September 11, 2006, at 9:40:56
Rhodiola sounds promising with tianeptine. Yesterday I took 75mg (half a tablet) of moclobemide with my regular normal tianeptine dose, and it was OK. Low dose moclobemide is slightly unpleasant but very clarifying for me. At least I managed to do something. Today I'm taking 1mg deprenyl citrate as well as the tianeptine.
I got slight headaches to begin with on tianeptine but it was no big deal.
Posted by Declan on September 11, 2006, at 15:20:20
In reply to 18 months on tianeptine (Stablon), posted by sukarno on September 9, 2006, at 8:17:29
G'day Paul
Nice to see you.
Tianeptine's been great. I can't imagine a better AD for me. Perhaps not so good if you're really depressed. It's comforting. Maybe I've been on it 4 months or so.
Declan
Posted by ed_uk on September 12, 2006, at 14:40:03
In reply to Re: 18 months on tianeptine (Stablon) » sukarno, posted by Declan on September 11, 2006, at 15:20:20
Dec,
What dose of tianeptine do you take?
Ed
Posted by ed_uk on September 12, 2006, at 15:48:35
In reply to 18 months on tianeptine (Stablon), posted by sukarno on September 9, 2006, at 8:17:29
Hi Sukarno
Good to hear from you :)
>famotidine 40mg QID
You take 40mg four times a day? That's quite high, I don't think it's a problem though. People have taken much more.
Ed
Posted by Declan on September 12, 2006, at 17:01:08
In reply to Re: 18 months on tianeptine (Stablon) » Declan, posted by ed_uk on September 12, 2006, at 14:40:03
Hi Ed
I take 12.5mg 3 or 4 times a day. Had insomnia from (I assume) the deprenyl last night, unless it was the double vodka or the alpha lipoic acid.
Declan
Posted by Declan on September 12, 2006, at 17:46:40
In reply to Re: 18 months on tianeptine (Stablon), posted by Declan on September 12, 2006, at 17:01:08
Onme of the descriptions of tianeptine is as a psychotonic.
Posted by myblusky on December 12, 2006, at 14:34:51
In reply to Re: 18 months on tianeptine (Stablon), posted by sukarno on September 11, 2006, at 3:47:26
Sukarno - Thank you for continuing to post about your experience on Stablon. I really appreciate you taking the time 18 months later to post about your positive experience with this medication.
I am very interested in Stablon because so far, the side effects from SSRI's and Wellbutrin have been pretty bad. I'm trying Prozac again, but if the fatigue and headaches don't go away, I will order the Stablon from overseas (I'm in the US and of course it isn't approved here).
Thank you again for all of the detailed posts.
Posted by traceytastsgr8 on May 21, 2007, at 23:51:28
In reply to Re: 18 months on tianeptine (Stablon), posted by myblusky on December 12, 2006, at 14:34:51
i am going to start on Stablon next week after years of failed rx. From reading previous posts, zoloft and paxil for example are horrific to use, you should note that in a bi polar situation maybe that is hurting your progress. they make you manic. help me with your experience balance this.with stablon, and a benzo i would guess. this is my last try. i am in nyc. i am afraid of weight gain.
t
Posted by sukarno on May 22, 2007, at 4:30:18
In reply to Re: 18 months on tianeptine (Stablon), posted by traceytastsgr8 on May 21, 2007, at 23:51:28
Good luck with Stablon. It is a mild antidepressant relative to the SSRIs and works in a different way, so I think it shouldn't cause mania. It just keeps me (mostly) out of depression, whereas Prozac and its clones (Paxil, Celexa, Zoloft) made me very nervous, wired, and agitated...borderline paranoid.
Not sure about weight gain, but that isn't a listed side effect and I've never gained any weight on it. :-) Let us know how it goes.Paul
Posted by Ayuma on August 29, 2007, at 20:32:22
In reply to Tianeptine tolerance, depression returns, posted by sukarno on July 9, 2005, at 11:31:28
I just ordered Stablon on the net. 120 tablets for 100 U.S. Dollars. If/When I receive it in the mail I plan to take it Not daily. I personally do not accept the idea of having to take a drug daily (i.e. being enslaved by the pill.) I'm not willing to be brainwashed by anything as I did with Prozac. Due to my past (bad!) experience with Prozac, I'll proceed with Extreme Caution when it comes to serotonegic drugs. Bascially I take 5-htp or St. John's Wort (all these herbs made me feel lazy and even estrogenic.).
Posted by Ayuma on August 29, 2007, at 20:37:16
In reply to Tianeptine tolerance, depression returns, posted by sukarno on July 9, 2005, at 11:31:28
I just ordered Stablon on the net. 120 tablets for 100 U.S. Dollars. If/When I receive it in the mail I plan to take it Not daily. I personally do not accept the idea of having to take a drug daily (i.e. being enslaved by the pill.) I'm not willing to be brainwashed by anything as I did with Prozac. Due to my past (bad!) experience with Prozac, I'll proceed with Extreme Caution when it comes to serotonegic drugs. Bascially I take 5-htp or St. John's Wort (all these herbs made me feel lazy and even estrogenic.).
Posted by linkadge on September 1, 2007, at 17:53:35
In reply to Tianeptine Not Daily, posted by Ayuma on August 29, 2007, at 20:37:16
What do you mean by the herbs make you feel estrogenic?
I am not doubting what you say, just curious.
Linkadge
Posted by sukarno on September 2, 2007, at 4:21:37
In reply to Re: Tianeptine Not Daily, posted by linkadge on September 1, 2007, at 17:53:35
The half-life of tianeptine is only 2.5 hours. This is very short and according to a psychiatrist I know, taking it less than 3 times a day wouldn't be advisable as it would lack efficacy.
As far as I know, all antidepressants, with the exception of fluoxetine (Prozac), must be taken daily, with the short-acting compounds being taken more than once a day.
Posted by tammytab on September 25, 2007, at 1:55:27
In reply to Re: 18 months on tianeptine (Stablon), posted by sukarno on May 22, 2007, at 4:30:18
I tried Stablon for a few weeks. I definitely noticed some positive effects right away - more energy yet an overall sense of calm, no more insomnia, brightened mood. However, a few weeks into taking it (3x day) I had a couple of severe crashes where I fell into some of the deepest pits of depression I have ever experienced. It's tough to say whether or not that was the Stablon or my situation. I'm now on Wellbutrin XL and it's kept me completely level, but I don't have the sense of peace that came with the Stablon. I'm very interested in trying the two together but am not sure how productive that would be. If anyone has experience with that please post it!
Posted by Ayuma on September 25, 2007, at 18:20:09
In reply to Re: Tianeptine Not Daily, posted by linkadge on September 1, 2007, at 17:53:35
Posted by Ayuma on September 25, 2007, at 20:07:54
In reply to Re: Tianeptine Not Daily, posted by sukarno on September 2, 2007, at 4:21:37
> The half-life of tianeptine is only 2.5 hours. This is very short and according to a psychiatrist I know, taking it less than 3 times a day wouldn't be advisable as it would lack efficacy.
>
> As far as I know, all antidepressants, with the exception of fluoxetine (Prozac), must be taken daily, with the short-acting compounds being taken more than once a day.
>
>Thanks a lot for providing the info. I've been put on (by myself)* Tianeptine 3 weeks ago. So today it's my third-week completion. About every other day I also take 100 mg of Modafinil for better motivation and energy. I then would add caffeine for my exercise and weight lifting sessions about 3~4 times a week and Stablon really seems to help prevent the terrible "crash" that usually comes during or after an intense/heavy free-weight workout plus some sugary post-wk drinks afterwards. Basically stablon seems to act like a stimulant that allows me to experience a very euphoric workout at the gym while listening to my I-Pod the music sounded amazing giving better motivation and intensity instead of giving up and leaving the fitness centre sooner. From within past three weeks I started with 2 tabs a day, and then a few days later I make it up to 3 tablets a day ... and then one morning I woke up with a not-so-pleasant feeling of over-stimulantion (I.e rapid heartbeat, "fight or flight" getting stucks) by Stablon so I cut it back to 2 a day. And then, just 3 to 4 days ago I suddenly experience a "crash" I was terribly depressed so I immediately up the dosage to 4 to 6 tablets a day and then I am perfectly fine again. Overall it seems to be somewhat of a difficult drug to work with, but certainly not impossible , either. (It's nothing - Nothing compared to the last generation of SSRIs that came with a vast array of unbearable side effects and addiction or withdrawal symptoms, etc..) It just takes patience and time, and - my long term dosages are not guaranteed since locally I can't find a physician who even knows what it is too new. No insurance of any kind but I find it isn't difficult to purchase it in bulk with fairly cheap price online, that is - so long you're lucky enough that you don't run into problem with the local Customs. (Stablon isn't a controlled substance so far.)
Posted by Ayuma on September 29, 2007, at 23:46:34
In reply to Re: Tianeptine Not Daily, posted by linkadge on September 1, 2007, at 17:53:35
I mean that some herbs such as St. John's Wort or the nutrient 5-htp or soy amongst others they all raises serotonin in the brain and as a result of more serotonin it also means more Estrogen in our bodies that causes side effects such as fatigue haziness lack of motivation aggressiveness, etc. Male (and sometimes, female) bodybuilders try to avoid anything that raise estrogen ... therefore, their better solution would be anti-depression through adrenaline or dopamine means. A good one is cocaine, but since in reality nobody use it anymore we all turn to Zyban or the newer generation of anti-depressants that raise male hormone instead of turning one into a wuss or sis. (I mean for a MALE !!!!!!!!! )
> What do you mean by the herbs make you feel estrogenic?
>
> I am not doubting what you say, just curious.
>
> Linkadge
Posted by sukarno on September 30, 2007, at 15:26:28
In reply to Re: Tianeptine Not Daily (follow up for linkadge), posted by Ayuma on September 29, 2007, at 23:46:34
I just did some googling and it appears that estrogen can increase serotonin levels, but I'm not sure if serotonin can raise estrogen. I guess it's possible.
There is a large group of people who suffer from post-SSRI sexual dysfunction that persists long after the SSRI was discontinued. In many of these cases, the hormone testosterone was low and their doctor prescribed them testosterone.
I feel amotivational, fatigued and a bit emotional at times. I also have almost no libido whatsoever. I'm not on SSRIs though and this has been going on long before I began taking Stablon in March/April 2005.
Dopaminergic drugs would be interesting. I know they help libido, energy, motivation and depression in many cases. The sad thing is that pharmaceutical companies keep developing serotonergic drugs and one of the few good dopaminergic drugs, namely amineptine, was removed from the market in 1999.
I've heard that pramipexole (Mirapex) has been useful when used off-label for treatment-resistant depression. It is a dopamine agonist (D2/D3 receptor agonist).
Posted by fuchsia on October 1, 2007, at 8:08:09
In reply to Re: Tianeptine Not Daily (follow up for linkadge), posted by Ayuma on September 29, 2007, at 23:46:34
>t of more serotonin it also means more Estrogen in our bodies that causes side effects such as fatigue haziness lack of motivation aggressiveness, etc. Male (and sometimes, female) bodybuilders try to avoid anything that raise estrogen ...
I am a female and when my oestrogen is higher I feel the opposite of what you describe ie I am more energetic, more motivated and in a better mood. When it falls I get the symptoms that you describe that you get when the oestrogen is increasing.
fuchsia
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