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18 months on tianeptine (Stablon)

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.

:-)


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