Posted by sukarno on September 1, 2005, at 12:20:05
In reply to Re: Maximum dosage for Stablon (tianeptine) » sukarno, posted by rod on July 19, 2005, at 3:41:53
Hi everyone. I hope all is well with the folks on psychobabble. :-)
Well, I had tapered down the tianeptine to 1 tablet a day in late July, but the depression and anxiety came back. In fact, I experienced some "rebound" panic attacks and a fuzzy-headed sensation, but nothing major. No withdrawal symptoms to speak of.
At the suggestion of my psychiatrist I went back to 12.5mg 3x/day (TID). My depression and anxiety almost immediately responded and I felt much better. However, about 10 days later the depression began to return, so I increased the dose to 4x/day.
Here I am a few weeks later and it is beginning to "poop out" again.
What causes antidepressant "poop out"? I have read this is official termed "tachyphylaxis" (i.e. a rapid "immunity" to the effects of a drug).
I really feel hopeless right now, even though I've taken the third dose of the day. What shall I do next?
I do have some amineptine here and am seriously considering taking that despite it having been pulled from the market because numerous studies have proven its long term safety, whereas with tianeptine it seems that a lot of the claims made for this particular drug cannot be proven. I might be wrong though...but there are few studies available on tianeptine compared with amineptine.
I wonder if I can take amineptine along with tianeptine or try a cross-taper, where I would gradually decrease tianeptine whilst adding amineptine at small doses and gradually increasing it.
In other news, I quit Xanax abruptly on 31 July and substituted with Valium 10 to 20mg for every 1mg of Xanax and rapidly tapered the dosage down.
Now I am on a relatively low dose of 10mg 2x/day (BID) diazepam (Valium) and am well-controlled in terms of panic attacks and anxiety. It took a while to adjust to this dosage as the dosage of Xanax was 5mg/day (equivalent to 50 to 100mg Valium depending on which equivalency charts you read).
I feel much better in terms of anxiety. I no longer have panic attacks at night and no interdose anxiety.
I'm just really feeling hopeless about this situation with tianeptine. I suppose I could increase the dosage to 12.5mg 5x/day or 2 tablets twice a day and one before bedtime (to avoid nightmares).
I can't take SSRIs or conventional TCAs. I won't consider MAOIs either because all of these drugs, or at least most, are metabolised by CYP2D6, which means I would have to take 1/20 the standard dose, just like I did with Prozac. Even at 1mg per day, Prozac was quite strong and mind-numbing, so I reduced it to 0.5mg per day and it worked just fine, however I am allergic to it now.
If anyone has any suggestions... or rather, what would you do if you were me? I am thinking of hospitalisation, but am not sure if that is the right thing to do.
Take care everyone,
Paul
poster:sukarno
thread:474445
URL: http://www.dr-bob.org/babble/20050901/msgs/549652.html