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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 68. This is the beginning of the thread.
Posted by Trotter on October 5, 2008, at 17:20:05
Hi everyone out in Dr Bob land! My first post.
50yo male living in Australia.
Probably been clinically depressed for at least 10 years, but possible that I would have been diagnosed with depression as a child as I have never been very happy.
I've been on the AD merry-go-round for around 8 years. Typical story. Been on and off lots of meds. Either didn't work or side effects outweighed the benefit, usually the latter. Tried most of the SSRIs, Venlafaxine, Mirtazapine, Reboxetine, Bupropion, Modafinil, Dexamphetamine as well as alternative supplements like SAMe, St Johns Wort, Tyrosine, fish oil, vitamins, Phenylalanine, DHEA. Never tried TCAs or MAOIs - had too many side effects on the other ADs!
The solution I settled on for a couple of years was Fluvoxamine and a tiny amount of Olanzapine to help me sleep. This kept me out of depression but in a sort of limbo land. My feelings and emotions were blunted and I was not very interested in other people. Sex was problematic.
Towards the end of 2007 I weaned myself off Fluvoxamine and Olanzapine and had another try without any meds. This brought me more in touch with my feelings and my cognitive function improved. Sex got better for a while, then sank again. Perhaps this is the depression, but I also suspect some long term SSRI damage. My mood and energy levels gradually dropped back to my non meds base level, so I'm now vulnerable to depressive episodes again.
5 days ago I started Tianeptine. So far I haven't experienced any severe side effects. My sleep has been disrupted to some extent, but manageable. My blood pressure shot up after the first dose - I saw my MD a few hours after the first tablet. He said come back in a couple of weeks to see if has come down. I have noticed a stimulant effect at times. Some slight headaches. My haemorrhoids have played up a little, probably caused by high blood pressure. Anyway, so far so good. Obviously I would like the BP to come down, but I am optimistic this is a temporary stimulant-like side effect.
For five years I have kept a daily record of my mood on a spreadsheet in order to analyse all the factors that may affect my mood. I rate my daily mood on a scale of 1-9. I have had only one day when I achieved a rating of 9. This was the first day I took Modafinil. I didn't feel euphoric, just fully alive. I wondered at the time whether this was how most people felt much of the time. Never had another 9 on Modafinil. A couple of 8s, then my brain decided I was way too happy and gradually downregulated me pretty much all the way. I suspect Modafinil acted as a stimulant by raising dopamine. Interestingly I did not experience any benefit from Dexamphetamine. Modafinil affected me similar to caffeine, only better.
I am hoping to have a good response to Tianeptine. I hope it raises dopamine in a sustainable way. I also hope it reverses the damage to my brain caused by chronic stress. I also hope it has a positive serotonin action, as I do respond to SSRIs. My worst AD was the SNRI Reboxetine. I note with interest Tianeptine reduces plasma NA. This also is a good indicator.
I've read with interest many of the babble posts about Tianeptine and Agomelatine. I'm excited about the potential of Agomelatine, especially considering my chronic sleep problems. However it is sensible for me to give Tianeptine a good try first as AD responses are very individual and there is no guarantee Agomelatine will work for me.
I would appreciate status updates on others using Tianeptine.
Posted by Sigismund on October 5, 2008, at 18:26:16
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Hello and welcome
I took tianeptine for nearly 2 years and it was very good for most of that time, helping me to get out and about.
Toward the end it made me feel weird and anxious, so I stopped taking it without any difficulty.
I too am looking forward to agomelatine.
Posted by Phillipa on October 5, 2008, at 20:54:18
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Sigismund on October 5, 2008, at 18:26:16
Welcome to babble you sound so friendly and optomistic. Glad to Have you here. See You have already found a poster from your country. Great to have you here. Phillipa
Posted by Trotter on October 5, 2008, at 21:16:14
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Sigismund on October 5, 2008, at 18:26:16
>> Toward the end it made me feel weird and anxious, so I stopped taking it without any difficulty.Thanks Sigismund. Sorry you had to stop Tianeptine. Is there any possibility that something else was causing the weirdness and anxiety? Did you experience these effects for a prolonged period before stopping? It must have surprised you to get such effects popping up after 2 years. I can understand it pooping out, although I was hoping Tianeptine wasn't like that, but causing weirdness and anxiety that far into treatment is a worry.
Posted by Trotter on October 5, 2008, at 21:31:50
In reply to Re: Tianeptine and Agomelatine » Sigismund, posted by Phillipa on October 5, 2008, at 20:54:18
> Welcome to babble you sound so friendly and optomistic. Glad to Have you here. See You have already found a poster from your country. Great to have you here. Phillipa
Thanks Phillipa for those kind words. You sound like a nice person.
Posted by Phillipa on October 5, 2008, at 23:26:32
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 21:31:50
Trotter I try to be!!!!! Love Phillipa
Posted by Sigismund on October 6, 2008, at 0:09:33
In reply to Re: Tianeptine and Agomelatine » Sigismund, posted by Trotter on October 5, 2008, at 21:16:14
>Is there any possibility that something else was causing the weirdness and anxiety?
Well, I don't think so. I still have tianeptine but when I take it I get that feeling. It's not THAT bad; it's just not useful.
>Did you experience these effects for a prolonged period before stopping?Certainly for some months, in response to which I lowered the dose, bearing in mind those people who say it makes them feel weird and nervous but who find it OK in small doses.
>It must have surprised you to get such effects popping up after 2 years.It did.
>I can understand it pooping out, although I was hoping Tianeptine wasn't like that, but causing weirdness and anxiety that far into treatment is a worry.I have no idea why. Perhaps it repaired my brain and now I am entirely well :)
Posted by Trotter on October 6, 2008, at 0:49:36
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Sigismund on October 6, 2008, at 0:09:33
Thanks for your clarification regarding weirdness and anxiety after long term Tieneptine use. Not really what I wanted to hear starting out on it, but I guess it makes me a bit more realistic in my expectations. I was under the impression that any side effects would be short term in nature. Maybe I'll be lucky, and then there's always Agomelatine, and then the next one .....
Posted by Tomatheus on October 6, 2008, at 1:00:52
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
> I would appreciate status updates on others using Tianeptine.
Trotter,
Welcome to Psycho-Babble. Thank you for sharing your medication experiences with us.
I currently take 37.5 mg of tianeptine for depression associated with schizoaffective disorder. I've been taking the tianeptine with Abilify for more than two months, and as a whole, I'd say that I've noticed a mild reduction in my depressive symptoms since I started taking it. I don't feel like I'm in full remission, and the tianeptine doesn't address all of my symptoms (for example, it doesn't help with hypersomnia). I have, however, noticed that it boosts my mood some and also my energy levels to a lesser extent. Most importantly, it's relatively consistent in its effects and hasn't induced any kind of mood cycling. So, I'd say that I'm getting a partial-but-consistent antidepressant response from it, which is more than I can say that I get from most antidepressants. I've found it to be a pretty good medication.
Tomatheus
Posted by Quintal on October 6, 2008, at 2:18:31
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Hi Trotter,
I've taken tianeptine on and off for years and it has always worked when I came back to it. I had a very nasty bout of depression in June and tianeptine brought me out of it and back to normal in under a week. I've been taking it for three months now (the longest I've ever taken it) and it works just the same as it did in the beginning. I suppose the degree of remission depends on what sort of response you're looking for from a med. I just want to feel mellow and content with the world, and I find tianeptine is great for that. Someone looking for something to rev them up and give that 'ready to take on the world' type of feeling may feel they're not getting the full antidepresant response they want from tianeptine.
The biggest problem I've had is that it sometimes causes 'spaciness' and lack of focus. I presume this has something to do with its anti-NE effect. I also take Lamictal and I think that contributes to the poor focus. I have tried adding noradrenergic meds to it with some success, but they come with their own problems.
The thing I like most about tianeptine is that I still feel the full spectrum of emotions, and of course that my sexual parts are still functioning. It is a good med and I recommend it to everyone who has had no luck with SSRIs etc. It doesn't work for everyone, and sometimes people try to ruin it for people who have, but I'd recommed you give it a good long trial - provided nothing untoward crops up of course. I too am very excited about agomelatine and it is high on the list of meds I want to try next, as much out of curiosity as anything else. I hope tianeptine works well for you.
Q
Posted by Trotter on October 6, 2008, at 4:33:23
In reply to Re: Tianeptine and Agomelatine, posted by Quintal on October 6, 2008, at 2:18:31
Hi Quintal, thanks for your update.
> The biggest problem I've had is that it sometimes causes 'spaciness' and lack of focus. I presume this has something to do with its anti-NE effect. I also take Lamictal and I think that contributes to the poor focus. I have tried adding noradrenergic meds to it with some success, but they come with their own problems.
I am experiencing this 'spaciness and lack of focus' at the moment, but I am hoping this is transient. Much too early to tell (day 6).
>
> The thing I like most about tianeptine is that I still feel the full spectrum of emotions, and of course that my sexual parts are still functioning. It is a good med and I recommend it to everyone who has had no luck with SSRIs etc.I am not looking for a miracle with Tianeptine. I will be happy if I can get a significant improvement in symptoms with negligible side effects. If I can get the same response I had with Fluoxetine, but without the crap, I'll be very happy - figuratively speaking :)
It doesn't work for everyone, and sometimes people try to ruin it for people who have, but I'd recommed you give it a good long trial - provided nothing untoward crops up of course. I too am very excited about agomelatine and it is high on the list of meds I want to try next, as much out of curiosity as anything else. I hope tianeptine works well for you.
>Thanks. I have a good feeling about this one.
Posted by Trotter on October 6, 2008, at 4:45:44
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Tomatheus on October 6, 2008, at 1:00:52
Thanks Tomatheus,
I'm not familiar with schizoaffective disorder type depression but I guess it is more complicated than my garden variety unipolar depression. Sorry Tianeptine doesn't help your hypersomnia. Can I trade you some of my insomnia? A couple of nights a week should do it. Just enough to pay off my sleep debt :)
From what I've read, your mood and energy levels may continue to improve for another month yet on Tianeptine. I would be interested to know if it does.
Posted by Trotter on October 9, 2008, at 14:37:25
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Day 10 on Tianeptine.
I have noticed a general increase in emotional sensitivity. This is most noticeble when I feel strong negative feelings such as anger, hatred, paranoia, but I am also aware of a greater desire to make social connection and sometimes a sexual urge too.
A couple of times I have experienced a nice stimulant effect, when I definitely felt more energised and I felt the urge to be active - to engage in hedonic pursuit. With my chronic anhedonia this is almost a forgotten feeling!
As far as depression goes, no improvement yet. In fact my daily mood ratings reveal a significant downturn since starting Tianeptine. I don't think the Tianeptine has actually worsened the depression. I think what happened was that I became more stressed than usual by some negative social interactions in the past week or so (because I have been more emotionally sensitive). My depression is usually worse the day after a stressful event. I think my underlying depression is unchanged, but my stress levels have been higher, giving the depression more opportunity to raise its ugly head.
Is this info helpful to anyone? I need to decide whether to provide regular updates on my Tieneptine experience or not.
Posted by Phillipa on October 9, 2008, at 19:56:15
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 9, 2008, at 14:37:25
Your reaction to stress is just like mine day after or a couple. Phillipa
Posted by Trotter on October 9, 2008, at 21:26:10
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Phillipa on October 9, 2008, at 19:56:15
> Your reaction to stress is just like mine day after or a couple. Phillipa
Do you think this means anything? I suspect this link of depression following a day or two after stress is not an uncommon experience with depressed people, but I wonder if it provides some indication of what in particular is wrong with our brains and what type of AD might be most responsive. Tianeptine is supposed to repair the hippocampus which is often atrophied due to depression related stress. Do you think this makes it more likely I will have a good response, or is it simply a fact that all types of depression involve stress?
Posted by clipper40 on October 10, 2008, at 3:16:39
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 9, 2008, at 14:37:25
Yes, I am finding your updates helpful since this is a medication I'm considering trying. Thanks.
Posted by Trotter on October 10, 2008, at 14:14:20
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by clipper40 on October 10, 2008, at 3:16:39
> Yes, I am finding your updates helpful since this is a medication I'm considering trying. Thanks.
Hi Clipper,
You're a fellow psychonaut, am I right? Sounds like we might be on a similar path. Have you also tried a pretty wide range of prescription meds to no avail?
Regards, Trotter
Posted by Trotter on October 10, 2008, at 14:35:45
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Day 11
Still feeling "spaciness and lack of focus" first mentioned by Quintal. I can also relate to a sense of "weirdness and anxiety" mentioned by Sigismund. I am forgetting to do things, including routine habits. Short term memory is affected. I have to think hard sometimes to remember whether I took my Tianeptine dose or not.
Trotter
Posted by clipper40 on October 10, 2008, at 15:17:38
In reply to Re: Tianeptine and Agomelatine » clipper40, posted by Trotter on October 10, 2008, at 14:14:20
Yes, I'm a psychonaut too! I've tried a lot of medications as well. I have no trouble finding medications that work for my anxiety but the depression and lack of motivation are another story.
Posted by clipper40 on October 10, 2008, at 15:21:07
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 10, 2008, at 14:35:45
Strange symptoms since I've read that tianeptine is supposed to be good for focus/concentration. Hopefully the spaciness and anxiety will diminish soon.
Posted by Tomatheus on October 10, 2008, at 18:06:52
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 9, 2008, at 14:37:25
Trotter,
As a fellow tianeptine user, I find your updates to be helpful and informative. It's always interesting to read about how others respond to psychiatric medications in general, IMO.
Tomatheus
Posted by Phillipa on October 10, 2008, at 18:44:59
In reply to Re: Tianeptine and Agomelatine » Phillipa, posted by Trotter on October 9, 2008, at 21:26:10
Trotter you feel all depression involves stress? Know quite a few who only experience anxiety. Phillipa
Posted by Trotter on October 10, 2008, at 19:21:46
In reply to Re: Tianeptine and Agomelatine » Trotter, posted by Phillipa on October 10, 2008, at 18:44:59
> Trotter you feel all depression involves stress? Know quite a few who only experience anxiety. Phillipa
I know my depression involves stress. I can't say that everyone's depression involves stress, although I think I have read that some scientists believe that to be the case. I am 100% sure that not everyone who experiences stress gets depressed. I think the popular theory with depression is that most sufferers have a predisposition (genetic and/or early childhood experiences) and an episode is triggered by a stressful event. I don't know much about anxiety, but I would expect stress triggers anxiety in those with a predisposition for anxiety.
Trotter
Posted by Trotter on October 14, 2008, at 23:10:16
In reply to Tianeptine and Agomelatine, posted by Trotter on October 5, 2008, at 17:20:05
Day 15
No really significant side effects, so I can understand how this drug has a low reported side effect profile, yet that doesn't mean it's all plain sailing.
My unanswered mail is building up, my favorite project is lying idle, I'm not answering my phone, I'm looking for excuses to avoid social commitments .... These are all signs of worsening depression. I seem to get worse on most ADs before they eventually kick in. This one is no exception. I'll get through it.
Posted by Phillipa on October 14, 2008, at 23:28:26
In reply to Re: Tianeptine and Agomelatine, posted by Trotter on October 14, 2008, at 23:10:16
Trotter really you get worse first? I hope it starts to turn around for you soon and don't forget to keep writing babblemail me also. Love Phillipa
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