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Re: Stablon (tianeptine) with SSRI?

Posted by Brainbeard on July 10, 2009, at 16:49:39

In reply to Stablon (tianeptine) with SSRI?, posted by atmlady on July 9, 2008, at 12:31:27

Reacting to the original question: although through a (completely) different mechanism than the SSRIs, the net result of tianeptine's actions on the serotonergic system is in part identical to the SSRIs. The juicy details:

'Chronic administration of tianeptine increases the density of serotonin innervation in the forebrain. (.....) like SSRIs, tianeptine promotes growth of serotonergic axons in the layer IV of the neocortex and forebrain limbic structures, notably the shell region of the nucleus accumbens.' (From David Pearce's 'The Good Drug Guide';

Preskorn states: '(.....) tianeptine shares with the classical antidepressants the ability to reduce the expression of the SE transporter mRNA and the number of SE transporter binding sites'.*

To my layman's eyes that seems to come pretty close to serotonin reuptake inhibition after all.

Anyway, the bottom line of all this mumbo-jumbo seems to be that adding tianeptine to an SSRI is not counterproductive but means extra boosting of the serotonergic system (plus, of course, some dopamine boosting, not to mention all the other good stuff tianeptine is doing to your brain).

My personal experience is that tianeptine, like the SSRIs, in the longer term DOES flatten my emotions somewhat, and promotes pleasure seeking behaviour in me, as do the SSRIs.
Dave Pearce seems to have experienced the emotional flattening too, as he writes in his drug diary (

'I explored tianeptine (Stablon), which is certainly less anxiogenic [than selegiline, BB]; but eventually my emotions felt flatter rather than deeper, consistent with its reported partial cross-substitution with fluoxetine (Prozac).'
[the reported effect is linked to:]

Both in theory and in practice, the serotonergic effects of tianeptine might not be that different from the SSRIs after all. Which is not to say that it's not a unique drug with some very interesting properties.

* Sheldon H. Preskorn, Tianeptine: A Facilitator of the Reuptake of Serotonin and Norepinephrine as an Antidepressant?, in: Journal of Psychiatric Practice, Volume 10(5) September 2004, 323-330




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