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Groping In The Dark

Posted by Brainbeard on November 2, 2010, at 16:42:47

In reply to Re: Should I tell my pdoc about stablon? Conundrum, posted by hyperfocus on November 2, 2010, at 13:55:07

> With drugs like tianeptine you can't measure their effects using a bucket. The base action could be described as raising or lowering the levels of neurotransmitter X, but the truth is we don't have a clue what these drugs do in the brain.

Close to the truth, but still a bit of an overstatement.

We do know that the net result of tianeptine's effect on serotonin transmission is similar to that of SSRI's. As Doctor Preskorn has observed in an excellent article on tianeptine: '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'.*

Several people, including myself, have noticed that tianeptine can flatten mood in a way similar to SSRI's, although more mildly so.

You rightly observe that tianeptine has many mechanisms. As an atypical TCA, tianeptine may have effects on the opioid system similar to other TCA's. For another thing, tianeptine has effects on glutamate. We're not just groping in the dark here.

* 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

Current meds: clomipramine 225mg, fluvoxamine (Luvox) 50mg
As needed: bethanechol 25-50mg, oxazepam 5-10mg




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