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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Helena24 on September 23, 2009, at 6:59:31
Hi,I'm reading this forum for the last couple of years and I am thankfull that it exists!
I do not feel very confident about my English but I will try...
I've been struggling all my life with depression and un-diagnosed ADD.
Now I am nearly 32 and I feel my life is pretty screwed up (if that's the correct spelling).
I tried nearly every drug available in my country.
It must have been many dozents different substances.I also obtained Ritalin illegaly a few times and I had a very good reaction to it.
All my symptomes dissapeared within half an hour.
Sadly I had to quit due to high cost and fake sugar pills if you understand...Ritalin is never prescribed in my country...
After 10 years of searching I found a doctor that prescribed Concerta for me but my reaction to it was very bad.
It made me more depressed and zombie-like.
Nothing like Ritalin.Since I got to the conclusion that my problen is due to low dopaminergic function (propably because of my genes/family history of alcoholism/obesity/procrastination), I've been
searching for legal compounds that could enhance
dopaminergic function for the last 12 or so years.I've tried l-dopa,sellegine,
amandatine,moclobemide,mirtrazapine,agomelatine,
st john's wort and others.... of wich only
st john's wort (kira) brought *some* good results.Since my reaction to SSRI were to lower my motivation in a degree that I felt disabled and since I know that serotonine lowers dopaminergic function,I was looking for a copound that was
"anti-serotonergic" and that would indirectly enhance dopamine.During my "investigations" I found tianeptine that I ordered from an online pharmacy for the first time 3 years ago.
TIANEPTINE
From the first day I took it the "working" dose was 6 pills (12,5 mg each)3 times a day.
3 years later I'm still taking this dose,(although somewhat "caotic"),so there has been no "tolerance" in means of needing a higher dose.
It still works good for my depression but the motivation-kick I experienced at the beginning is very much gone.I can't motivate myself for doing a lot of important things and I can't finish my studies at the university...I'm doing nearly nothing all day.
This lines I can only write because of the tianeptine.
Here is the problem: I can only do something productive (for a few hours)if I take 6 (or more pills of tianeptine) and only if I'm interested enough.
I have no income and I hardly can efford this large doses of the med.
I don't feel that there is a serious medical reason to quit taking the drug...it has no side effects at all.But when I quit I experience withdrawal symptoms, myalgia,lack of motivation,only sitting there and doing nothing and lots more...
I did withdraw some weeks ago (I dindn't order in time) and these symptoms last for two weeks or so and then I got back to "baseline"...then there was the package in the mail and...I couldn't resist.
It's a real lose-lose situation.
On the one side the need for large doses of an expensive drug wich doesn't alleviate all of my symptoms,only makes my depression somewhat bearable but doesn't restore my functioning to a "healthy" degree, and also the knowledge to
depent on a drug just to feel "normal".On the other side my "amotivational" debeliating depression and ADD symptoms.
This is probably 1/1000 of my story...I could write a book about my drug experiences.
I hope I didn't make to many language-mistakes.Anyone out there with tianeptine dependency or some thoughts to share?
Posted by SLS on September 23, 2009, at 7:22:39
In reply to Tianeptine addiction, posted by Helena24 on September 23, 2009, at 6:59:31
Have you tried sulpiride? If so, how did you respond to it? It is thought that low dosages of this drug (100mg) can boost dopamine by preferentially blocking autoreceptors. It is relatively inexpensive.
- Scott
Posted by Helena24 on September 23, 2009, at 7:33:47
In reply to Re: Tianeptine addiction » Helena24, posted by SLS on September 23, 2009, at 7:22:39
Yes I've tried Sulpiride.
It's nearly for free in my country and can be obtained over the counter.It helps a bit for anxiety and mood but it makes my concentration worse.
I can't read something when I am on this drug.
It does very little for motivation for me.I nevertheless think that it is a good drug.
In fact I suggested it to my mother sometime ago and she is doing fine with a low dose of it...
Posted by desolationrower on September 24, 2009, at 2:47:51
In reply to Re: Tianeptine addiction, posted by Helena24 on September 23, 2009, at 7:33:47
you've tried an nri like desipramie or reboxotin?
-d/r
Posted by Helena24 on September 24, 2009, at 4:24:44
In reply to Re: Tianeptine addiction, posted by desolationrower on September 24, 2009, at 2:47:51
Yes.
For many years these drugs were not available in my country.I searched for them desperatly 10 years ago.
In 2003 I traveled to another country to by desipramine.
I had a good reaction to it in very low doses 25mg/day.Higher doses were contraproductive/made it worse.
A cocktail that was good for me was 200mg Modafinil+25mg Desipramine in the morning +100-200mg Seroquel(for sleep).
My functioning was good for a while but it fadet with time.Desipramine and Reboxetine aren't available and I would have to order them via internet.
Desipramine is a good drug but Stablon is much better for my symptoms.
I never tried them in combination though.I think I could benefit from a larger dose of 24 or even 30 pills Stablon per day but that would be to expensive at this time.
I can get every drug available in my country over my health-insurance.
Tianeptine isn't available but even if it were no doctor would prescribe it in these amounts.I would give any money that I have for a drug that would restore my functionig completly.
Sadly Tianeptine doesn't at this point.If I had free access to drugs I would add some Ritalin or Dexedrine to the Tianeptine but that isn't possible.
Doctors in my country are very biased and there are strict laws.I never tried Parnate wich also isn't available.
I would try it.I took Provigil for a long time and dindn't have to pay a penny for it.
100-200mg Provigil+ 225mg of Tianeptine worked wonders for me in 2007 but then it stopped working.
I didn't took Provigil for some months and perhaps it will work again in the future.Provigil alone isn't enough to manage my symptoms...
I think I should stop Tianeptine for some months and than start to take it again.
Perhaps than I could benefit again from its psychostimulant properties.I never tried Reboxetine.
I tried Strattera with bad results (depression/suicidility).Wellbutrin gave me concentration and memory problems and didn't work well for depression.
Trivastal (Piribedil) wasn't good either (increased my need for Benzos and made me eat to much).
Mitrazapine was activating for me and restored memory and concentration (it increases dopamine and norepinephrine in the frontal cortex due to 5HT receptor antagonism).I had to quit due to weight gain.
I recently tried Agomelatine wich at some points is similar to mitrazapine (5ht antagonism/ increases dopamine in PFC) but it make me very miserable and agitatet.
I have lost my patience with drugs and can't wait to long till they "kick in".
I stopped agomelatine after 10 days yesterday and I feel better now.
It's not worth the hype but that's only my oppinion.
I'm not a representative sample.I'M VERY ANGRY ABOUT THE SITUATION OF ADD ADULT SUFFERERS IN EUROPE.DOCTORS ARE IGNORING THE PROBLEM!
The situation is a little better in "rich" european countries (Germany,Switzerland,GB).
In "poor" southern Europe (Italy,Greece,Spain) there is practically no way for sufferers to get medication that is considered first-line treatment.
Posted by doxogenic boy on September 24, 2009, at 12:41:58
In reply to Re: Tianeptine addiction, posted by Helena24 on September 24, 2009, at 4:24:44
> 100-200mg Provigil+ 225mg of Tianeptine worked wonders for me in 2007 but then it stopped working.How long did that combination work?
My current combination:
1) quetiapine (Seroquel) 600 mg
2) liothyronine sodium (L-isomer of triiodothyronine (T3); Cytomel, Liothyronin)
10 µg (microgram)
3) escitalopram (Cipralex/Lexapro) 40 mg
4) tianeptine (Stablon) 150 mg
5) clonazepam (Klonopin, Rivotril) 1 mg
6) trimipramine (Surmontil) 100 mg
7) lithium (Lithionit) lithium sulphate 330 mg (= 42 mg Li+ or 6 mmol)doxogenic
Posted by Helena24 on September 24, 2009, at 14:50:34
In reply to Re: Tianeptine addiction » Helena24, posted by doxogenic boy on September 24, 2009, at 12:41:58
There are 2 sorts of "working":
1)working agains depression,dark thoughts, emotional outbursts, anger, anhedonia disphoria ,insomnia (tianeptine in the evening stimulates me but in the morning hours/after 4 it gives me a high quality sleep at the same dosage of 2-3 pills/maybe that's due to it's interaction with circadian cortisol levels or it's just my delayed shift disorder).
In this way tianeptine still works for me after 3 years/modafinil does do not much besides to get me up in the morning now.
2)the second way of working is agains apathy/procrastination/difficulty concentrating / ADD symtoms /LACK OF MOTIVATION /NOT STARTING THINGS
In this way the combination of tianeptine and modafinil worked about a year and a half although there were small periods during that time where it didn't work so good.(I needed a lot of will-power.)
Now tianeptine just "takes the pain away" and still does help me to do "easy" things like washing the dishes etc but not to start learning for exams and stuff like that.
Procrastination and fatique are my biggest problems.Still for me tianeptine is a live-saver.
It is the best AD I ever took and I took a lot.
I'm afraid I have to get off it for a year or so to make it "work" again in the *2nd* way.I have also a problem with social isolation.
I can't enjoy social relationships.
It's not anxiety,it's anhedonia.
Tianeptine never did a lot for this issue.
I have to force myself to socialize,I haven't the "drive" to do it.
High doses of tianeptine are much more stimulating and activating than the modafinil due to the dopamin-thing...modafinil just enhances the stimulating effect of the tianeptine...it's an augmentor.
Posted by doxogenic boy on September 24, 2009, at 15:33:32
In reply to Re: Tianeptine addiction, posted by Helena24 on September 24, 2009, at 14:50:34
> There are 2 sorts of "working":
>
> 1)working agains depression,dark thoughts, emotional outbursts, anger, anhedonia disphoria ,insomnia (tianeptine in the evening stimulates me but in the morning hours/after 4 it gives me a high quality sleep at the same dosage of 2-3 pills/maybe that's due to it's interaction with circadian cortisol levels or it's just my delayed shift disorder).
>
> In this way tianeptine still works for me after 3 years/modafinil does do not much besides to get me up in the morning now.
-----I have used modafinil some years ago, but it worsened my depression. Could it work better in combination with tianeptine and can modafinil worsen anxiety disorders?
> 2)the second way of working is agains apathy/procrastination/difficulty concentrating / ADD symtoms /LACK OF MOTIVATION /NOT STARTING THINGS
>
> In this way the combination of tianeptine and modafinil worked about a year and a half although there were small periods during that time where it didn't work so good.(I needed a lot of will-power.)
------This is interesting.
Maybe I should give modafinil (added to the tianeptine) a new try if the lithium augmentation doesn't work. I take tianeptine three times a day, and about one hour after each dose, I feel more calm. This effect may last up to a few hours.
> Now tianeptine just "takes the pain away" and still does help me to do "easy" things like washing the dishes etc but not to start learning for exams and stuff like that.
> Procrastination and fatique are my biggest problems.
------That are big problems for me, too. I have tried Dexedrine, but it increased the anxiey severely.
> Still for me tianeptine is a live-saver.
> It is the best AD I ever took and I took a lot.
>
>
> I'm afraid I have to get off it for a year or so to make it "work" again in the *2nd* way.
>
> I have also a problem with social isolation.
> I can't enjoy social relationships.
> It's not anxiety,it's anhedonia.
> Tianeptine never did a lot for this issue.
> I have to force myself to socialize,I haven't the "drive" to do it.
------Buprenorphine worked wonders against both my anhedonia and social phobia, but only for some months.
> High doses of tianeptine are much more stimulating and activating than the modafinil due to the dopamin-thing...modafinil just enhances the stimulating effect of the tianeptine...it's an augmentor.
-----Could 225 mg tianeptine work better than 150 mg?
Increasing the tianeptine dose is the easiest thing I can do.doxogenic
Posted by Helena24 on September 24, 2009, at 16:18:23
In reply to Re: Tianeptine addiction » Helena24, posted by doxogenic boy on September 24, 2009, at 15:33:32
> I have used modafinil some years ago, but it worsened my depression. Could it work better in combination with tianeptine and can modafinil worsen anxiety disorders?
Theoretically every stimulating drug can do this but everyone reacts different.
For me it never worsent anything but is just "pooping out" after a while.
I also combined modafinil with seroquel and I was well.I did add seroquel 25m to the modafinil+tianeptine combo occasionally to induce sleep.
The Lexapro you are taking should also work against anxiety but I feel that you take a lot of meds.Tianeptine has strong anxiolytic properties also.
I can't give you any advice only speak about my experience.
>
>
> This is interesting.
> Maybe I should give modafinil (added to the tianeptine) a new try if the lithium augmentation doesn't work. I take tianeptine three times a day, and about one hour after each dose, I feel more calm. This effect may last up to a few hours.
>
For me the "basical" med is the tianeptine.
Modafinil is good but I could live without it.
It's much easier to quit than the tianeptine.
There are articles who speak about tianeptine and modafinil working synergistically.>
> That are big problems for me, too. I have tried Dexedrine, but it increased the anxiey severely.
As I mentioned I can't get Dexedrine in my country.
Did you combine it with an anxiolytic medication?
> >
> >
>
> Buprenorphine worked wonders against both my anhedonia and social phobia, but only for some months.
>
>
I never tried opioids.
No way a doctor in my country would prescribe it for depression...NO WAY!!!
Did you have any withdrawal-symptoms when you stopped it?
>
> Could 225 mg tianeptine work better than 150 mg?
> Increasing the tianeptine dose is the easiest thing I can do.
>
> doxogenic
>In my experience this drug is like "the more you take the better you feel" at least this is how it works for me.
But the "dark side" is the addiction/discontinuation thing.
Only the thought that I will run out of the med causes me panic.
When I run out of it I turn to alcohol for comfort.
It's no fun.Combining so many meds as you do makes me feel worried although...
Tianeptine has some euphoric properties too,at least at the beginning and in high doses (75 mg at one time or more).
I felt that ssri interfered negatively with this.
They "block" euphoria...that's my impression.
Have you ever tried tianeptine without ssri?
(That's just a question/no suggestion).
Posted by doxogenic boy on September 25, 2009, at 11:36:43
In reply to Re: Tianeptine addiction, posted by Helena24 on September 24, 2009, at 16:18:23
> Did you combine it with an anxiolytic medication?
-------Dexedrine was combined with Cipralex (Lexapro) in small doses.
> > Buprenorphine worked wonders against both my anhedonia and social phobia, but only for some months.
> >
> >
> I never tried opioids.
> No way a doctor in my country would prescribe it for depression...NO WAY!!!
> Did you have any withdrawal-symptoms when you stopped it?
I had a terrible withdrawal which lasted for months after the first time I used it (in 2004).
(I was a short time on morphine after the buprenorphine).
Actually, I have never been the same after that experience, also because of the ECT I got. Still, I have tried buprenorphine two times after that, the last time without withdrawal, probably because of Seroquel.
> > Could 225 mg tianeptine work better than 150 mg?
> > Increasing the tianeptine dose is the easiest thing I can do.
> >
>
> In my experience this drug is like "the more you take the better you feel" at least this is how it works for me.
Maybe taking tianeptine even more often in a bigger total dose, will result in a shorter period every day with anxiety and depression.
> But the "dark side" is the addiction/discontinuation thing.
> Only the thought that I will run out of the med causes me panic.
> When I run out of it I turn to alcohol for comfort.
> It's no fun.
How does a tianeptine withdrawal feel?
> Combining so many meds as you do makes me feel worried although...
Yes, I don't think it is good for me, but I am afraid of getting the extreme anxiety back, so I don't take the risk to remove medication that may work when a new medication is added. But more medications than the existing ones, should I try to avoid.> They "block" euphoria...that's my impression.
> Have you ever tried tianeptine without ssri?
> (That's just a question/no suggestion).The first time I tried tianeptine was without SSRI and no other medication. After a week or less, I got a wonderful response, but it just lasted for a few days. For me, tianeptine has worked better in combination with escitalopram.
For more about SSRI/tianeptine, you may read this:
http://www.dr-bob.org/babble/20090826/msgs/914964.htmlI have also seen a case that showed that paroxetine added to tianeptine exacerbated depression, I searched for it now, but didn't find it. Anyway, I wonder if it works different when tianeptine is added to a SSRI compared with a SSRI added to an existing and working tianeptine.
In my case, tianeptine was added to escitalopram, with good effect, so I wonder if had been different if the tianeptine came first.
doxogenic
Posted by Helena24 on September 26, 2009, at 11:16:28
In reply to Tianeptine addiction, posted by Helena24 on September 23, 2009, at 6:59:31
>How does a tianeptine withdrawal feel?<
It's a severe craving, myalgia/flu-like symptoms,I felt very weak ,orthostatic hypotension , apathy ,no motivation ,extreme fatique ,insomnia (that I ,managed with bromazepam )
I had a strong craving for alcohol during this time.(Normally I drink only "social doses".
When I take tianeptine I have nearly no interest for alcohol.)
Some time ago I added paroxetine to the tianeptine (to loose some weight) (yes,for me paxil works as a weight-loss drug).
That resulted in needing much higher doses of tianeptine to manage the apathy/procrastination that comes from the ssri and this was not good for me and I soon stopped the paxil again.When I start an ssri it's better not to have tianeptine in the house because the temptation is to big to take large doses to manage ssri side effects.
It makes me to swallow the pills without control.
So combintation ssri+tianeptine does not work for me for this reason.The only reason for me to take an ssri would be to lose weight.
They are worthless for me for my other issues since anxiety is not a big problen for me.
Posted by zzzz7 on September 26, 2009, at 19:12:53
In reply to Re: Tianeptine addiction, posted by Helena24 on September 24, 2009, at 4:24:44
Two things I've used to increase dopamine (that is, two things other than the things you've mentioned) are green tea tablets and tyrosine.
Posted by Helena24 on September 27, 2009, at 4:45:22
In reply to Re: Tianeptine addiction, posted by zzzz7 on September 26, 2009, at 19:12:53
> Two things I've used to increase dopamine (that is, two things other than the things you've mentioned) are green tea tablets and tyrosine.
Any good results?
This is the end of the thread.
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