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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Marty on July 17, 2008, at 17:55:17
I'm looking for some idea of what could be good with Tianeptine. I'm looking for a stronger Antidepressant effect WITHOUT sexual/cognitive side effects.I'm thinking of resuming Wellbutrin .. but I'm very interested in your ideas..
/\/\arty
Posted by atmlady on July 17, 2008, at 18:46:59
In reply to ** Plz help: Any TIANEPTINE COMBO proposal ?, posted by Marty on July 17, 2008, at 17:55:17
Marty, I just received my order of stablon in the mail today, and the plan was to try it with strattera, but not immediately. I've made an appointment with a new doc and want to talk it over with him first - gotta wait till the end of the month. As for you, have you thought about wellbutrin + stablon? I have, and may try it at some point, who knows?
But yeah, I think we are ALL looking for that magic combo that alleviates our mood issues, assists with our own peculiar sleep and weight issues, and all with minimum impact on sexual and cognitive functions. So you can be sure that when and if I do try anything new, I'll be posting my results here. Every little bit of info helps, ya know? Cause unfortunately, finding the right combo seems to be a SWAG (scientific wild-*ss*d guess). But if we keep talking to each other about our experiences, we can make better SWAGs I would think.
Posted by bleauberry on July 17, 2008, at 18:53:44
In reply to ** Plz help: Any TIANEPTINE COMBO proposal ?, posted by Marty on July 17, 2008, at 17:55:17
I like my GPs approach and my pdocs approach...the fewer the meds the better. Sometimes we need more, but maybe there are other things to try first?
Did serotonin drugs help you at all? If so, maybe a tiny bit of 5htp might do the trick (5mg-20mg). Any benefit from fish oil for you? B vitamin complex? Minerals such as selenium, zinc, and chromium? Maybe a tiny smidgen of phenylalanine or tyrosine? Ever tried st johns wort (might consider low dose).
If you liked wellbutrin, maybe try as low a dose a possible and feel it out?
Or, give the Stablon a full 3 months before doing anything else. Further improvements may gently subtly creep up over time. Looking at clinical trials it seems to me some of the greatest benefits came after the trial period of 6 to 12 weeks was over and the drug was continued longer. It wasn't unusual for nonresponders or partial responders to be doing well at 9 months to 12 months. Since the drug is off to a good start, maybe just be patient and try to forget it for a few months and reassess things at some predetermined date on your calender?
Just some ideas to play with.
Posted by Phillipa on July 18, 2008, at 0:20:06
In reply to Re: ** Plz help: Any TIANEPTINE COMBO proposal ?, posted by atmlady on July 17, 2008, at 18:46:59
I thought tianeptine was good for cognitive defects? Love Phillipa
Posted by Marty on July 18, 2008, at 9:53:37
In reply to Re: ** Plz help: Any TIANEPTINE COMBO proposal ?, posted by atmlady on July 17, 2008, at 18:46:59
Hi AtmLady,
> Marty, I just received my order of stablon in the mail today, and the plan was to try it with strattera, but not immediately.
---
Sounds like something that could work. When you say 'but not immediately' I wish you also mean that you will not combo the 2 from day 1. I think it would be best to try one first then add the second a couple weeks later. That way if the combo fail you will know how you felt on the first one alone. At that point you can go and try the other one alone after a withdrawal of the first one OR keep taking only the first one. IMO it's a better systematic way of trying those meds. Do you agree ?
> As for you, have you thought about wellbutrin + stablon? I have, and may try it at some point, who knows?
---
Actually I was on Welbutrin when I started Tianeptine. After having a good effect from Tianeptine, I started to feel like it was pooping out on me... There a couple things that could have done this and stopping Wellbutrin could be the most important factor. I'll wait a couple day before shouting 'Eureka!!' since I just resumed Wellbutrin yesterday BUT.. Only one dose yesterday is enough for me to know there some synergistic stuff going on between Wellbutrin and Tianeptine (at least for me): Wellbutrin feel QUITE different when I'm on Tianeptine .. and this difference.. this feeling.. remembered me when Tianeptine was working great for me. :)> But yeah, I think we are ALL looking for that magic combo that alleviates our mood issues, assists with our own peculiar sleep and weight issues, and all with minimum impact on sexual and cognitive functions. So you can be sure that when and if I do try anything new, I'll be posting my results here. Every little bit of info helps, ya know? Cause unfortunately, finding the right combo seems to be a SWAG (scientific wild-*ss*d guess). But if we keep talking to each other about our experiences, we can make better SWAGs I would think.
---
I completely agree with you! I learned a great deal just by coming here in the last couple years. Beside learning, socializing with other 'sufferers' is helping a lot too.Thanks for answering AtmLady!
I'm looking forward to follow your experience with Tianeptine. Keep us posted!/\/\arty
Posted by Marty on July 18, 2008, at 10:44:34
In reply to Re: ** Plz help: Any TIANEPTINE COMBO proposal ? » Marty, posted by bleauberry on July 17, 2008, at 18:53:44
Hi Bleauberry,
> I like my GPs approach and my pdocs approach...the fewer the meds the better.
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"The fewer the meds the better." Anyone who already lived like a walking pharmacy for some time cannot disagree with this mantra. Some Pdocs just dont seems to get this one.. Some patients should wear a "The fewer meds the better." T-SHIRT before every appointment with them. :P>Sometimes we need more, but maybe there are other things to try first?
---
Well.. I've tried a lot of prescription meds and also a lot of supplements. The only things I didn't got to try are the TCA, which is wise to avoid since my main problem isn't finding something that works but finding something that works with an acceptable level of side effects. I'm pretty sensitive to those.. especially sexually and cognitively. Another reason for avoiding TCAs was because I'm possibly BP2 or the soon to be included in the DSM-V Bipolar type that is only switch hypomanic on ADs. That said I know Tianeptine is chemically considered a Tricyclic but so atypical clinically that it's most of the time not even relevant to specify it.
> Did serotonin drugs help you at all? If so, maybe a tiny bit of 5htp might do the trick (5mg-20mg).
---
They help a lot in the short term but I can't stand those in the long term... and being a chronic sufferer that is kind of a problem. Main problem is, like most who cannot stand pro-serotonergics, sexual side effects (even now having POST-SSRI SDs) .. bad judgment (abnormal thinking?) .. cognitively < vedgetables ... amotivational and emotionnal blunting. as for 5-HTP and Tryptophan.. been there, done that.
> Any benefit from fish oil for you?
---
Omega-3 in any form is making me more depressed in the mid-term and also cause me a lot of brain fog. Interestingly Omega-6 GLA (Evening Prim Rose) seems to help somehow.. in fact it's one of those rare supplements that I never stop taking (and I tried about 40 of them) .. If you have any interesting theory as of why it does, feel free to share it with me! .. my guess is that it's related to immunology/inflammation or hormonal modulation.
> B vitamin complex? Minerals such as selenium, zinc, and chromium? Maybe a tiny smidgen of phenylalanine or tyrosine? Ever tried st johns wort (might consider low dose).
---
B complex helped me in the 4 years I have been on Paxil but since then only increase my anxiety. If Tianeptine effect resume I may give it a try again.Selenium has an effect on me that reminds me neuroleptics I tried. Not antidepressant in my case.. the feeling is unpleasant but seems to make my thoughs more rational. May retry in VERY small dose in the future if I feel some hypomanic abnormal thinking pattern resurface.
Zinc.. after a couple of trial I'm not sure what it does to me. Maybe making me a little more dysthemic and irritable. (Testosterone?)
Chromium (NOT Picolate.. more protein bounded aka GTF) is an important part of my cocktail already. I consider it as important as any other prescription med I take. Atypical Depression may be part of my problems since Nardil as also been great to me.
I'm not sure about the effect of Thyrosine on me even after a couple trial. It seems to depend of some endogenous (biological?) factors. Phenylalanine may be one thing to try in the future, but only because it's one of the few interesting supplement I didn't tried. If the effects soda containing Phenylalanine has on me is of any indication I think it will be a very short negative trial.
> If you liked wellbutrin, maybe try as low a dose a possible and feel it out?
---
I was taking it when I started Tianeptine and I think stopping it may have been the biggest factor in my Tianeptine semi-poop out. I tried a dose yesterday and realized how much Wellbutrin was feeling different for me while being on Tianeptine. In fact this feeling remembered me the feeling of Tianeptine working for me! .. I think there's some synergy between both of them (in my case) and so I intend to resume fully Wellbutrin.
> Or, give the Stablon a full 3 months before doing anything else. Further improvements may gently subtly creep up over time. Looking at clinical trials it seems to me some of the greatest benefits came after the trial period of 6 to 12 weeks was over and the drug was continued longer. It wasn't unusual for nonresponders or partial responders to be doing well at 9 months to 12 months. Since the drug is off to a good start, maybe just be patient and try to forget it for a few months and reassess things at some predetermined date on your calender?
---
Amen to that. This is what I intend to do. Before starting Tianeptine I already intend to continue taking it for an extended period of time EVEN if I couldn't feel the AD effect. Brain atrophy, cause or effect of depression, cannot be a good thing and reversing/preventing it is no doubt for me a good thing !> Just some ideas to play with.
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Very good post actually!Thanks!
/\/\arty
Posted by Marty on July 18, 2008, at 10:46:48
In reply to Re: ** Plz help: Any TIANEPTINE COMBO proposal ?, posted by Phillipa on July 18, 2008, at 0:20:06
> I thought tianeptine was good for cognitive defects? Love Phillipa
Hi Phillipa,
Tianeptine is good for cognitive defects. What I meant was that if I was to add another AD to my combo that I wouldn't want the second one to have cognitive side effects. Sorry if it wasn't clear.
/\/\arty
This is the end of the thread.
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