Posted by Shawn. T. on September 11, 2002, at 2:35:51
In reply to Mirtazapine with Tianeptine, posted by Babak on September 10, 2002, at 8:01:43
You shouldn't have any problems with that combination, although consulting with your pharmacist on the issue would be advisable. Mirtazapine would likely offset tianeptine's potential side effect of insomnia. I could see tianeptine as a potential augmentation strategy especially for mirtazapine-resistant anxiety symptoms (some reports link high synaptic levels of serotonin to anxiety). As tianeptine efficacy has been shown to be highly correlated with REM density, mirtazapine would likely be an effective augmentation strategy due to its REM sleep enhancing qualities. See http://www.thieme.de/abstracts/pharmaco/agnp-abstracts1999/daten/147.html for a double bind clinical study of this phenomenon. You may want to check out Pineyro and Blier's excellent review on the autoregulation of serotonin neurons for an in depth pharmacological account of what is currently known about tianeptine. http://pharmrev.aspetjournals.org/cgi/content/full/51/3/533
If you decide that tianeptine may not be your best option, you could check out http://www.mhsource.com/pt/p020750.html for a decent discourse on currently known augmentation strategies for treatment resistant depression (the description of lithium's mechanism of action is unsubstantiated). Note that the combination of mirtazapine and bupropion is not mentioned, although I personally find the two to mix quite well (other personal reports support this notion, although no clinical studies have been conducted on the matter).
Shawn
poster:Shawn. T.
thread:119452
URL: http://www.dr-bob.org/babble/20020906/msgs/119527.html