![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 44 to 68 of 68. Go back in thread:
Posted by Phillipa on October 27, 2008, at 19:42:05
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 27, 2008, at 17:12:28
Trotter any idea what is next for you to try? Love Phillipa
Posted by peggyaus on October 27, 2008, at 19:57:42
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Hi Trotter,
I'm an Australian living in the US. Is Stablon available in Australia. Would you let me know from where/how you are obtaining it. I am interested in trying this drug.
Thanks for your help,
peggyaus
Posted by clipper40 on October 28, 2008, at 4:41:04
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 27, 2008, at 15:57:09
And some people may need both serotonin and dopamine (as well as norepinephrine and/or other neurotransmitters). Maybe you would have found some success combining the tianeptine with an SSRI or another tricyclic. If/when I try tianeptine, I will definitely take something along with it to control my anxiety, probably some doxepin.
Posted by dapper on October 28, 2008, at 19:51:29
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 27, 2008, at 17:12:28
Trotter, sent you a babble mail.
Posted by Trotter on October 28, 2008, at 21:54:33
In reply to Re: Tianeptine and Agomelatine, posted by peggyaus on October 27, 2008, at 19:57:42
I'm not sure if Babblemail is currently delivering my messages. So if anyone thinks I haven't answered, it's not that I haven't tried.
Trotter
Posted by Questionmark on October 29, 2008, at 16:08:23
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 27, 2008, at 15:57:09
This was incredibly insightful and brilliantly articulated.
Oh wow this has so much significance in terms of philosophy, psychology, AND behavioral pharmacology.
I have been thinking about almost the same exact things you discussed quite a lot lately, particularly in the past year. But you put words to some of the ideas that I could not-- or qualified them in a way that I have not been able. Brilliant.
I agree and think there is a significant amount of conflict between desire and acceptance or contentment. Buddhism seems to be particularly aware of this conflict and has been speaking about it for over two millenia since the Buddha himself is said to have given us the Four Noble Truths-- one of which states that all suffering is a result of desire (or attachment to desire/s) and another that the only way to free oneself from suffering is to free oneself from desire. The simple yet profound brilliance of that is always amazing to me.More practically speaking, I think it's possible to have an overall life of relative happiness and contentment, even of course if some amount of suffering remains (as is the case for every person who regards themselves as "happy" and "content"). But even this, however, requires an adequate balance between unfulfilled desire, and acceptance-- as you have said. If the amount of desire far enough exceeds the amount of acceptance, then unhappiness, discontentment, and painful depression can ensue. But, i think it is even possible for an extreme enough *opposite* imbalance (e.g. too little desire compared to acceptance, so to speak) to have negative consequences: namely boredom, numbness, apathy, and anhedonia-- up to even an emotionless, empty depression. Also, as you touched on, people can fail to improve their lives to the point that, if/when they do have a sufficient fall in acceptance or rise in desire, they are left with disappointment, pain, and depression.
And getting into the psychiatric context, THIS is why I think it can be very detrimental (at least or especially in the long run) for people to be on too high a dose of serotonergic [or other desire-reducing, acceptance-enhancing] antidepressants, and for some-- many-- people to even be on them at all. Depression is an evolutionary adaptation. It must be. Otherwise we would probably not experience it-- esPECially so many of us. And it makes sense. The more our lives and our selves become unsatisfactory, the more unhappy and eventually depressed we will become, and the more we will *desire* to try to change things. So if we drug everyone so that they are content no matter what, what effect will this have on the individuals and society??? Now certainly there are those who are excessively susceptible to depression, and there are those-- such as myself-- whose depressions are so severe as to warrant pharmacological assistance (thank mercy for Nardil!). But even THOSE people should be adequately informed and cautioned about the ramifications of the drug effects and *carefully* tried to be given the most ideal dose (meaning the minimum effective-yet-sufficiently life-assisting dose, in my opinion). Most doctors when prescribing a psychiatric medication are less cautious than a car mechanic in trying to fix a problem while still trying not to create or exacerbate other problems in the process. And, as important as a motor vehicle is, I would say that a person's brain and life are more important (and at times even more expensive to try to fix-- incidentally).
I'm rambling now sorry. But I've tried to explain some of these concepts and my correspondent concerns to some psychiatrists at different times (though not nearly as thoroughly), including the evolutionary role of depression and all that, but they just relate to me the same dogma about how depression is much more damaging than medications could be, and how untreated depression frequently grows worse and worse over time. It's not that I don't believe or agree with these views to a large extent, although I do unequivocally believe there are times when antidepressant drugs can be more damaging-- neurologically AND/or behaviorally-- than depression itself. I just want these doctors to also understand where *I* am coming from, and what I am saying, and to give it some consideration.
So where the hell was I? I suppose that's mostly it. One last thing.A lot of the time when people make a statement about one of the roles of a certain neurotransmitter(s)-- as most of us who discuss these matters including myself have done at one time or another-- it is a gross generalization and vastly oversimplified. But I really think there is a great deal of truth in what you have just stated about dopamine and serotonin and their roles in the experience of desire and acceptance & contentment. It's too bad we are not researchers and could test this in some way. Of course, it's also possible there are already studies out there which support this. (Or we could try to convince Dr. Bob to try start one :?) .)
Regardless, I think the ramifications of all this are pretty significant-- in a *number* of ways. Great insight and great job on pointing this out. There is a lot to be considered in relation to all this.
> I have spent a lot of time studying the nature of happiness. This has been motivated by a desire to be more happy (as in not depressed), but also because it is in my personality to want to understand things.
>
> In my research I have indentified a paradox between desire and acceptance. Desire leads to purpose, meaning, goals, passion and energy, all of which can contribute to a sense of happiness. On the other hand, acceptance, as in feeling satisfied with oneself and one's world also gives one a sense of happiness. Yet there is much conflict between the two. A highly motivated, passionate person will have great difficulty feeling contentment, and vice versa.
>
> Okay, you are no doubt thinking, where is he going with this? Well, I believe the desire system is largely controlled by dopamine, and acceptance/contentment is more a function of serotonin. If you suffer anxiety, low self-esteem and depression, then you will likely benefit from raising serotonin. If you suffer anhedonia, lack of energy, passion etc, then you will likely respond to increasing dopamine.
>
> A problem with this is that I believe there is a conflict between dopamine and serotonin. Raise serotonin and you lower dopamine (SSRI emotional blunting). My understanding is that Tianeptine raises dopamine by lowering serotonin. This can address anhedonia, but risks causing anxiety and dissatisfaction (lower serotonin).
>
> I tend to think whether one benefits more from a SSRI or Tianeptine is an individual thing based on one's relative lack of serotonin or dopamine. For me, I respond well to SSRIs, which probably predicts a poor response to Tianeptine. Does this make sense, or am I just rationalzing my decision to stop Tianeptine?
>
> Of course many depressed people suffer low serotonin AND dopamine, not to mention noradrenaline. Perhaps this explains why most ADs do not result in remission.
>
> Sorry if this reads like a psycho's babble. :)
>
> Trotter
Posted by Trotter on October 29, 2008, at 18:12:35
In reply to (Nature of Happiness: desire/acceptance, DA/5HT) » Trotter, posted by Questionmark on October 29, 2008, at 16:08:23
Hi Questionmark,
I agree very much with your post. I've sent you a Babblemail message. Not sure if you'll get it though.
Trotter
Posted by JadeKelly on November 2, 2008, at 2:38:02
In reply to Re: Tianeptine and Agomelatine, posted by missmolly on October 19, 2008, at 17:57:20
> Hello - I just wanted to say that I have been following your posts, and I appreciate the updates on your experience with Tianeptine. I am going to begin taking Tianeptine next week for the first time - although I have no current or history of depression. I am taking it because I have Huntingtons Disease - a heredity neurodegenerative disorder. HD's first effects on the brain are atrophy of the hippocampus - much the same as is seen in the brains of those who have major depression. In fact, the first symptoms of HD are usually depression - although I am not yet symptomatic. My neurologist has suggested I begin a Tianeptine regimine- as more of a 'hail mary pass' that this will delay the onset of the disease (other SSRI's are currently in clinical trials for the treatment of HD-but tianeptine has shown less side effects and similar neuroprotective benefits). There is currently no cure, and no treatments for HD. It is always terminal - so I am willing to try just about anything. I would greatly appreciate any information on expected side effects - or any predictions on what this will do to my mood, etc - as I am not depressed. I am in the US - and although my doctor is quite progressive, he doesn't seem to have much experience with this medicine either - so I'm trying my best to educate myself.
>
> Many Thanks to you all for sharing!
>
> ~MHi Miss Molly, I am terribly sorry to hear of your (recent?) diagnosis. You are most resillent to have dodged any depression so far. From what I've read, sounds like you caught it early and could have a long time to figure this out, especially with all the new drugs and discoveries coming our way. It was your doc who advised Tianeptine? If its an obvious choice for your condition, I wondered why it sounded like he didnt know much about it? Also, I know there aren't a lot of treatments available for this disease right now, but what about selegiline, if the tianeptine doesn't work, or, if they can augment each other? Seems Parkinson's is similar in its symptoms? Well I'm not a Doc, but I do hope you get the BEST DOC because I've seen it make the difference. I only mention selegiline because I know it to be neuro-protective, works well for depression for many (me), and may reduce symptoms. Not sure doses would be compatible for each symptom, but worth asking, right?
Hope to see you post again with your progress!!
Best wishes-Jade
Posted by JadeKelly on November 2, 2008, at 2:44:33
In reply to Re: Tianeptine and Agomelatine, posted by missmolly on October 19, 2008, at 23:31:38
Posted by missmolly on November 13, 2008, at 23:28:46
In reply to Re: Tianeptine and Agomelatine, posted by JadeKelly on November 2, 2008, at 2:38:02
Hi Jade - Thank you for the information! Just logged back on to give an update on how Tianeptine was going (want to report a few side effects, and ask if anyone has experienced them) and saw the new message :) Yes, I will definitely check into this other drug. You are correct that Huntingtons Disease has similarities to Parkinsons. Certainly they are both neuro-degenerative disorders that can possibly benefit from any drug with neuroprotective benefits. Right now there are no drugs specifically for HD, and most doctors are guessing at what can slow or prevent the onset of the disease while the researchers try to find something effective. There is now one new drug that the FDA approved specifically for HD, but its to help control the shaking (similar to Parkinsons)-but that is a long way off for me, and I am much more concerned with postponing the onset of the disease. More evidence is revealed each day that indicates that there are changes in the brains of people with HD up to 10 years prior to the onset of the noticeable symptoms of the disease. There may even be slight mental declines that are not debilitating -and most people probably attribute these to age and don't realize its the beginning of the disease... this news scares the heck out of me and I am more willing to try anything that could "protect" my brain from HD. Each time I lose my keys, or drop a pen - I'm certain its the beginning! If anyone has ever watched the show 'House' on Fox - HD is the disease that Olivia Wilde's charachter "Thirteen" was diagnosed with at the end of last season - and how she's dealing with the news that she has it is a story line this season. I met with the producers of the show two years ago and I was interviewed throughout the process of my testing. When I first met with them I was at risk, then I got the test and they followed up with another interview about my behavior and reactions to the news. (She even came to my work and had lunch with me to talk about it to 'research' her character! Although I can't claim her character is based on me - Hehe...I promise I never went through a drug fueled, lesbian, risk taking phase to deal with my diagnosis, that was 100% the writers!)
To answer your question, I was recently diagnosed through a genetic test at a clinic that specializes in HD (the HD Center for Excellence at UCLA), but I live outside LA so I see a local neurologist - but plan to go back to UCLA once a year to participate in an ongoing study they have (just an observational study that watches our brains and behaviors change over the years-not a drug study unfortunately). Since it is such a rare disease, most neurologists have only seen one or two cases-and often times it is the patient advising the doctor. After I expressed my desire to try anything that may delay the onset, he contacted the specialists at UCLA and did some research on previous studies about different drugs and even supplements that have neuro-protective benefits. This is how he learned of Tianeptine- and I am the first he has prescribed this to (neither he or any of the other HD doctors have prescribed it before, since its not in the US- so I'm a bit of a guinea pig :)
I've now been on it for about two weeks, I started out at a low dose and have slowly increased up to the full dosage he wants me on in just the past few days.
I've had a few strange side effects that may still subside (my doctor thinks these may be temporary)- but I thought I'd share them here anyhow. Maybe some of you have experienced these symptoms? ...or maybe these are unique to a non depressed, pre-HD mind on a long-shot drug ;)
First, I have had the absolute craziest dreams I've ever had in my life! I don't even know if I can call them dreams because they seem so real. The first time it happened- I really woke up and wasn't sure if it was real or not. It always happens right as I'm falling asleep, literally like I'm still half awake- and the dreams almost mirror reality. I am lying in my bed, when suddenly a feeling a sheer terror comes over me (though I'm not really sure what I'm afraid of sometimes). A couple times I've felt like something or someone was standing in my doorway to my bedroom. When I go to scream, or move or whatever- I am completely paralyzed. Then I realize I'm not even breathing (hopefully just in my dream!). A feeling of sheer terror/panic comes over me, and at some point I realize I'm dreaming and wake myself up- buts its eery to wake up into the same setting as my 'nightmare' (if you can call it that?). A couple times, I have even thought I was awake only to have it happen again - it was like I woke up in my dream, was relieved that I was awake and it had just been a nightmare, then the feeling of terror and paralization came back. In my dream I thought I had awoken, and it was really happening when I was awake, because I'd already woken up from the nightmare once!(geez, I just read that and it made no sense-hopefully you can follow me!). Anyway, it is the strangest thing ever - and it happens every night. Its become less terrifying though, as it seems that now I am aware its a dream from the beginning and I know that it will end. I've also found that if I change positions and lie on my side or stomach it doesn't happen -not sure why?! My doctor said that vivid dreams were sometimes a side effect of anti-depressants, so I'm trying to just stick to it and hope they will subside now that my dosage has leveled off. Has anyone else experienced nightmares from their meds?? Is this common?? My only other side effect is that I am a little more emotional. (I was secretly hoping maybe I'd be really happy since I'm not depressed normally...but that doesn't seem to be the case;). I'm not necessarily more or less depressed or happy in general, I just seem to have more reactive emotions. I'm generally very even keel- it really takes a lot for me to cry, and it has to be something dramatic or traumatic that affects me or someone I care about, like a breakup or death or something (not just like a bad day or bad news for example). But since I've been on the tianeptine, I'm a little bit weepy! That sounds like I'm depressed, but thats not it - I tear up at things like when I'm watching something sad on TV.(the local news got me tonight...a 10 yr old boy with only a week to live who has Leukemia and his last request was to feed the homeless with donations...I was a puddle!). Little things like this, usually something positive or touching, have me in tears. Its not like depression, where I'm sad and crying about something thats going on with me. Its almost like having my hormones out of whack or something. I have never cried at a wedding, but I've got one coming up this weekend and I'm just going to pack some kleenex in my purse! I hope emotional stuff passes too- although its not necessarily a negative thing, but I'm sure It'll drive my family crazy eventually!
I've read about Tianeptine helping people who have apathy. I'm wondering if it has an emotional heightening effect that helps those with apathy . Has anyone else experienced this? Does it pass or lessen with time?
Last, does anyone know if Tianeptine is supposed to have an effect on your weight? Does it make you lose or gain weight? I forgot to ask my doctor, I definitely will at my next appointment. The doctors tell us that if we are pre-HD we should keep our weight up (not the worst thing to have your doctor tell you :).One symptom of the disease is that we burn up to 5000 calories per day just sitting around. I am very concerned with this, because my mothers weight was a problem throughout her illness and she eventually required a feeding tube. I want to make sure I keep my weight up a little or that I just don't get too thin. I've been trying to gain a little, and haven't had much luck - I'm wondering if Tianeptine could be affecting this?
Thanks again Jade for your suggestion. I will ask my doctor about this, and certainly consider switching or adding if the benefits are similar and the side effects are less. Where did you learn that it's neuro-protective? Do you have any links or suggestions to find some documentation I could take to my doctor to ask about it?
Best ~ M (currently crying at tv commercials :)
Posted by Tomatheus on November 15, 2008, at 2:30:04
In reply to Re: Tianeptine and Agomelatine, posted by missmolly on November 13, 2008, at 23:28:46
Missmolly,
Thank you for your detailed post.
I can't say that my nightmares have become any worse since I started taking tianeptine. I sometimes have nightmares, but for me, they're not any worse than they were before I started taking tianeptine. I'm sorry to hear that you're struggling with this side effect.
I wish that I could answer your question about weight and tianeptine. I am not aware of any relationship between tianeptine and weight gain/weight loss, but that doesn't mean that there isn't any. I can say that I've been taking tianeptine myself for more than three months and haven't gained or lost any weight.
Thanks again for your post,
Tomatheus
Posted by missmolly on November 16, 2008, at 13:16:49
In reply to Re: Tianeptine and Agomelatine » missmolly, posted by Tomatheus on November 15, 2008, at 2:30:04
Thanks Thomatheus! That is good to know about the weight. I haven't been able to find much online that links tianeptine to weight loss or gain, so hopefully your experience and the lack of information on the web is indicative that it doesn't have much effect one way or another on weight.If I may ask, have you experienced any other side effects? Is this something you plan to take for a long time, or just for a short period? You can message me if you'd prefer.
Thank you! ~M
Posted by BillW on November 22, 2008, at 3:36:21
In reply to Re: Tianeptine and Agomelatine, posted by missmolly on November 16, 2008, at 13:16:49
Posted by desolationrower on November 22, 2008, at 16:05:17
In reply to Re: Tianeptine and Agomelatine, posted by missmolly on November 16, 2008, at 13:16:49
>
> Thanks Thomatheus! That is good to know about the weight. I haven't been able to find much online that links tianeptine to weight loss or gain, so hopefully your experience and the lack of information on the web is indicative that it doesn't have much effect one way or another on weight.
>
> If I may ask, have you experienced any other side effects? Is this something you plan to take for a long time, or just for a short period? You can message me if you'd prefer.
>
> Thank you! ~MI didn't gain weight on it; like other side effects, it is no higher on tianeptine than placebo. It isn't any better than other antidepressants, but it does have a very low side effect profile.
-d/r
Posted by Trotter on November 22, 2008, at 17:33:31
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
I have still not recovered from taking Tianeptine for a month. My week to week mood was lower the whole time I was on it, and now, even a month after stopping, my mood has not reverted back to how it was before starting Tianeptine. In fact I have plunged into severe depression.
Why? My theory is as follows: I respond well to selective serotonin reuptake inhibitors and Tianeptine is a selective serotonin reuptake enhancer (opposite action). As many will know, SSRIs work by immediately raising serotonin, but typically the AD benefits only flow through after 3 weeks or so, and continue to increase up to week 12. Similarly when coming off SSRIs, it is usual to derive some benefit for up to 12 weeks, even though serotonin levels are reduced in days.
Unfortunately what I have experienced is the opposite. By lowering serotonin my mood has been lowered, and will probably not totally get back to a pre-Tianeptine level until 12 weeks after stopping.
What's to be learnt from this? Well, I would advise against taking Tianeptine if you respond to SSRIs. And if you do give it a try, and it lowers your mood over the first couple of weeks, best to stop and cut your losses rather than persevere, or you might end up in my situation.
Trotter
Posted by BillW on November 24, 2008, at 4:30:00
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on November 22, 2008, at 17:33:31
Tks Trotter, I was on Effexor for a few years, and with it, I became more aggressive. Now with Tianeptine for about a month, actually it helped me on the panic attack, except that my energy level remains low. no much initiative to do things, and tend to avoid problem solving.
This is my forth day on Effxor, and I am taking 2 x 75 mg instead of the prescript 75mg a day just to speed thing up. The first 2 days was bad, with hairy feeling in my palm, but now seemed to improve a bit. May be I will take 75mg by tomorrow.Billy
Posted by Trotter on November 26, 2008, at 14:10:24
In reply to Re: Tianeptine and Agomelatine, posted by BillW on November 24, 2008, at 4:30:00
I suppose you realise that Effexor inhibits serotonin reuptake, while Tianeptine enhances reuptake. From one perspective, these meds might be acting to nullify each other.
That said, I have wondered for a while how Effexor or a SSRI might go with Tianeptine. There is a chance that Effexor will help maintain serotonin levels while allowing Tianeptine to do its thing of increasing neuroplasticity. If this happens you might be on a good thing.
Good luck, Trotter
Posted by clipper40 on November 28, 2008, at 7:45:25
In reply to Re: Tianeptine and Agomelatine » BillW, posted by Trotter on November 26, 2008, at 14:10:24
Hey Trotter,
I would never have thought to combine tianeptine with an SSRI if it hadn't been for a thread on this here a short while ago. I had assumed that they would be at cross purposes also but I believe at least one person posting in that thread had a positive experience with the combination. Don't remember any of the specifics though.
Posted by Marty on November 28, 2008, at 9:09:24
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by clipper40 on November 28, 2008, at 7:45:25
Also, there's medical case report about a woman for which Tianeptine and another SSRI she tried didn't worked alone, but when taken together she got a total remission of her symptoms.Now if only I could find the case report on pubmed... I tried and wasn't able. Anyway it doesn't says more than that in the abstract.
/\/\arty
Posted by BillW on November 28, 2008, at 9:25:58
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by clipper40 on November 28, 2008, at 7:45:25
Yes I tried it a few years ago, another doctor gave me 225mg Effexor and asked me to take one 12.5 mg Tianeptine. At that time I did not have any idea that they worked in opposite way. I think I felt more calm with this combination but I cud not be sure. When I took 3x12.5 mg Tianeptine a few weeks ago, I felt that it gave me more relax feel, but a slight lack of energy. My panic attack and my hairy feeling on my palm was gone, but I do not have energy, and felt sad easily. However, i only took it for about 2 weeks. Some time if I take 5x12.5mg, I actually felt quite good, relax and quite happy. I might try to add 1 or 2x of it in combination of my 75mg Effexor...
Bill
Posted by psychobot5000 on November 28, 2008, at 23:35:17
In reply to Re: Tianeptine and Agomelatine » clipper40, posted by Marty on November 28, 2008, at 9:09:24
Hi Marty,
Haven't been active on this board for a couple years now, but I frequently used to post on Tianeptine a while back. Always interested to hear new case studies--always wondered about how it would interact with an SSRI. If patient's positive reaction was due to the medications, that would seem to be another blow to the serotonin hypothesis, would it not?
Anyway, I wanted to ask you a question (if you don't mind). So feel free to email me (backwards format) at
moc.oohay@seiks_eht_kcarcThanks in advance,
Psychbot>
> Also, there's medical case report about a woman for which Tianeptine and another SSRI she tried didn't worked alone, but when taken together she got a total remission of her symptoms.
>
> Now if only I could find the case report on pubmed... I tried and wasn't able. Anyway it doesn't says more than that in the abstract.
>
> /\/\arty
>
>
Posted by BillW on November 29, 2008, at 13:51:30
In reply to Re: Tianeptine and Agomelatine » Marty, posted by psychobot5000 on November 28, 2008, at 23:35:17
Today I took a 12.5mg at night, in combination of 150mg Effexor when I woke up in the day. I feel that Tianeptine is more effective in removing panic attack.
Will try for a week or so, let see.
Posted by clipper40 on November 30, 2008, at 8:15:42
In reply to Re: Tianeptine and Agomelatine » clipper40, posted by Marty on November 28, 2008, at 9:09:24
Hi Marty!
Interesting about that woman. Maybe some of us have been thinking about this wrong. Maybe the serotonin reuptake enhancement from tianeptine is like adding a dopaminergic effect and so you're adding that to an SSRI rather than counteracting it. Does that make any sense?
Posted by Marty on November 30, 2008, at 10:33:44
In reply to Re: Tianeptine and Agomelatine » Marty, posted by clipper40 on November 30, 2008, at 8:15:42
Hi Clipper :)
To me, it does somehow but I see the story as more complex than that. We babblers most of the time talk about "levels" of neurotransmitters in term of more or less but very rarely in term of WHERE. As an example, Agomelatine melatoninergic action is mainly in the hypothalamus and is mainly in the frontocortical dopaminergic and adrenergic pathways. WHERE a drug has an effect matters a lot ! Now, Tianeptine doesn't increase serotonin reuptake everywhere in the brain, but only in some specific regions... so trying to figure out what Tianeptine + SSRI does is probably futile for people who aren't neuroscientist. Let's say for the sake of simplicity that the SSRI of that woman
was increasing synaptic serotonin level in every region of her brain. The addition of Tianeptine would in theory (in part) decrease synaptic serotonin level in a 'patchy way'.. in only some regions... now add to that the secondary mechanism of the 2 antidepressant (ex: Tianeptine act on one Adenosine receptor and except for Citalopram all SSRI act directly on other system than the serotonergic one)... figuring out what's the effects of that mix in the brain or the clinical effect a person with X or Y disorder etc is about the neuroscience equivalent of high level theoretical physics mathematic ... :P I don't say that it isn't fun to try figuring out how drug works and interact and learn about of the brain works etc I do like that for some reason. But the more you learn and the more you feel it's most of the time fantasies when we, layman, try to hypothesize in neurology.I wish we had a neurologist/neuropsychiatrist/neuroscientist coming on the forum from time to time for a little chat on neurology and psychopharmacology. That would be great! but for many reasons isn't very probable .. lol
Sorry Clipper for that babbling of mine, but I feel like sharing that brief moment of lucidity with someone ;)See ya in 'our own space' ..
/\/\arty> Hi Marty!
>
> Interesting about that woman. Maybe some of us have been thinking about this wrong. Maybe the serotonin reuptake enhancement from tianeptine is like adding a dopaminergic effect and so you're adding that to an SSRI rather than counteracting it. Does that make any sense?
>
>
>
Posted by clipper40 on December 1, 2008, at 4:43:12
In reply to Re: Tianeptine and Agomelatine » clipper40, posted by Marty on November 30, 2008, at 10:33:44
Excellent point, Marty. I hadn't even thought of that. Duh!
Definitely not your only moment of lucidity. You are always sharp and on the money when it comes to the science behind these things.
Yeah, see on "our own space". :)
This is the end of the thread.
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