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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by bleauberry on July 27, 2008, at 19:23:54
Do you have some time to help me on Tianeptine? I am very prone to side effects, very sensitive to meds, and often have paradoxical reverse reactions to them. As a result, my drug trials are usually short-lived. If I can make it past day 4 on anything, that is a major accomplishment. Usually by that time I am ready to drive myself to the hospital I am so much worse than I started in some way or another.
Don't want that to happen with Tianeptine, since it is off to an ok start. That itself is unusual for me. So any help you can share is greatly appreciated.
You suggested going for the full dose right away? Yeah? That sounds scary. Tell me more about that. More anxiety at low doses, smoother at higher doses?
Insomnia or poor sleep issues? Did they go away on their own?
What times of day do you take your doses? What size doses?
After 8-12 hours of no dose (assuming last dose was at dinner and then 8 hours of sleep), is there a withdrawal felt at waking? I have a hard time discerning whether how I feel in the morning is disease-related or med-related.
Massive headache today. Common or not?
Did you get as fast a response as I did? After you did notice a response, did it continue to get better with time?
Anything else you can share on tianeptine besides just my questions is welcome. Thank you very much for your thoughts.
Posted by Quintal on July 28, 2008, at 15:19:15
In reply to Quintal....Questions for You, posted by bleauberry on July 27, 2008, at 19:23:54
>You suggested going for the full dose right away? Yeah? That sounds scary. Tell me more about that. More anxiety at low doses, smoother at higher doses?
I understand you being scared because of your sensitivity to other meds, but I hope this early positive response is enough to convince you tianeptine is different territory to other meds. Really, the side effect profile of tianeptine is so mild I doubt you'd run into serious side problems at the normal dose. I don't really know if tianeptine causes more anxiety at low doses because I haven't taken less than two tablets a day for any length of time. All I can say is that starting out at four tablets a day I never had that side effect.
>Insomnia or poor sleep issues? Did they go away on their own?
I don't think insomnia was much of a problem when I took it in the past. I take zopiclone now so I can't really tell, but I don't think it's causing insomnia.
>What times of day do you take your doses? What size doses?
Breakfast, mid-afternoon or whenever I remember, and just before supper, an hour or two before I go to bed. I take one tabet at a time, if I'm taking four tablets I take one with each meal. When I was feeling very bad I dosed myself with a tablet every two or three hours and this kept the depression at bay. At the most I think I was taking six or more tablets a day. I find it's very flexible like that. I did take two tablets together once and felt very strange. I had to go and lie down.
>After 8-12 hours of no dose (assuming last dose was at dinner and then 8 hours of sleep), is there a withdrawal felt at waking? I have a hard time discerning whether how I feel in the morning is disease-related or med-related.
I don't think there's any withdrawal in terms of symptoms like electric shock type things you might get with SSRIs. It's more that the depression creeps back in overnight as the drug wears off. That's why I say it's a bit like a drug of abuse in that you get a very rapid onset of action and you can usually feel it wearing off (in terms of 'wanting' another dose). But I wouldn't say it has much abuse/addiction potential for some reason. I'm usually like a bloodhound round drugs of abuse, but I haven't detected much potential in tianeptine. It's about the closest thing you can get IMO to a 'non-abusable' opiate/benzo/stimulant.
>Massive headache today. Common or not?
I don't think so. It might be a co-incidence or maybe it's just your body getting used to the drug. I suppose you might have to resign yourself to things like this during the settling-in period, but hopefully they'll go away after a week or two.
>Did you get as fast a response as I did? After you did notice a response, did it continue to get better with time?
I did last year when I took it. I remember within an hour or so I felt much better, all warm and melty like a tub of butter left out in the sun. I wasn't particularly depressed at the time though. Last month I was very depressed, and although I did feel some relief with a few hours it wasn't until the sixth day that the depression finally went away. But six days! It was one of those pea-souper depressions too. I couldn't see any way out and thought it wouldn't work, but then I woke up on the sixth day almost laughing.
It did get better over the coming weeks and I think it's reached a plateau now. I've never taken tianeptine longer than about two months, so I don't know if my response would change over the longer term.
I suppose you could try adding a small dose of Xanax to help with the anxiety. It could just be a startup side effect like some people get with SSRIs. I don't know what to suggest about the longer term, but if this is one of the few drugs that has worked for your depression I'm sure I don't have to tell you that it's worth exhausting all the options before giving up on it, including trying the upper dosage range of four tablets or more.
Q
This is the end of the thread.
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