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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by sukarno on December 3, 2007, at 5:23:38
I've read that tianeptine doesn't produce much in the way of physical dependence when tapering or stopping. There are stories out there of people who abused it, taking up to 240 tablets per day, and then detoxified in an inpatient setting over a period of four days or so and didn't have major problems. I guess what that means is "the patient didn't die!". heh.
I have found tapering to be more difficult the longer I remain on Stablon.
I tried tapering from 12.5mg 4x/day by taking 1/2 tablet less. That seems reasonable. I've tapered faster in the past without major problems.
Well, this time was a total disaster. I started getting a throbbing headache, reduced appetite/mild nausea and anxiety. The worst symptom was what I call "rebound depression". My depression came back so badly. It was just absolutely horrible and I don't wish that on anyone.The reason why I lowered the dose was due to financial concerns as it is expensive (56 cents/tablet). That's the only reason I tried to reduce the dose.
My wife insisted that I go back to the previous dose, so I did and I began to feel better. The headache took a few days to go away.
I never expected any of this to happen so I will have to conclude that while this drug is good for anxiety and depression, it can produce physical dependence similar to that of other antidepressants. SSRI withdrawal seems to be a lot worse though.
The sad thing is I never read anywhere that this drug could produce bad withdrawal symptoms. Probably the medical community thinks symptoms like headache, nausea, anxiety and rebound depression are "mild" and nothing of concern, but I would have to differ with them about their definitions of mild.
I also felt cravings for it too. It's not difficult like quitting smoking, but it's pretty hard, both psychologically and physically.Can anyone else here relate to this? I mean, specifically with tianeptine (Stablon) and withdrawal.
Thanks,
Paul
Posted by Sigismund on December 5, 2007, at 18:32:50
In reply to Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on December 3, 2007, at 5:23:38
Hi Paul
Tianeptine turned nasty on me, for some reason or other.
Instead of feeling nice on it I began to feel (for want of a better word) uneasy. Maybe agitated?
Anyway this was after a year of no problems on 3 or 4 per day.Since then I have halved the dose to 1/2 tab 3 times a day, without brain zaps.
I may have breakthrough depression, it's hard to say.
My state of mind is problematic, which is the norm for me.After this morning's half I again felt weirdly stimulated, almost distressed.
I'm hoping I will just be able to stop without difficulty, but naturally worry that things will get worse.
Very recently I tried adding ashwaganda and SAMe (200mg am), and thought it was a good idea at the time.
So maybe for me stopping it will be less of a problem than continuing to take it?
I may titrate.
Posted by desperately seeking on April 27, 2009, at 6:17:31
In reply to Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on December 3, 2007, at 5:23:38
Hi
I'm glad I found your thread. I've been on tianeptine for 5 months to help me deal with the SSRI withdrawal. I'd been on SSRIs for 6 years so I was pretty suicidial etc when I stopped and Stablon helped calm me down a little and get me through the days. But I read an article saying that your nervous system needs time to adjust, so you shouldn't take anything ( no herbs, no meds no 5htp, no vitamins) and just leave your brain and body alone for a couple of months.
I had been on Stablon for 5 months so I decided to try taper it down. But I've effectively swapped one drug dependency for another. I went from 4x a day to 3x a day and I'm feeling the effects just on the first day! Nausea, dizziness, slowness and the return of the really deep, painful depression and insomnia. It is a shame that the companies always mention the great thing about being on the drugs but don't mention trying to come off the drugs. I guess maybe they think you'll be on it forever??
To me that makes Stablon as bad as SSRIs, valium or any other drug. They're all the same. Stablon is meant to have less side effects than SSRI. I wouldn't say so. I think it's just a milder drug. I still felt unnatural on it. Slight depersonalisation, a little too calm in some instances when maybe I should have been feeling a different emotion. However, this could be the combination of the SSRI withdrawal with a new drug that's pulling the brain in an entirely new direction from what it's become used to over the years.
Bottmom line, ultimately, you have to deal with whatever it is that's making you feel bad about life. My experience ( and this is just MY experience) is that antidepressants actually just cloud my brain and alter my mind-state to the point where I don't even know if I'm coming or going anymore. So I can't even begin to deal with the emotions I'm experiencing in a rational, level-headed way.
Just my opinion. Any others agree...?
Posted by desperately seeking on April 27, 2009, at 6:31:22
In reply to Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on December 3, 2007, at 5:23:38
Hi
I'm glad I found your thread. I've been on tianeptine for 5 months to help me deal with the SSRI withdrawal. I'd been on SSRIs for 6 years so I was pretty suicidial etc when I stopped and Stablon helped calm me down a little and get me through the days. But I read an article saying that your nervous system needs time to adjust, so you shouldn't take anything ( no herbs, no meds no 5htp, no vitamins) and just leave your brain and body alone for a couple of months.
I had been on Stablon for 5 months so I decided to try taper it down. But I've effectively swapped one drug dependency for another. I went from 4x a day to 3x a day and I'm feeling the effects just on the first day! Nausea, dizziness, slowness and the return of the really deep, painful depression and insomnia. It is a shame that the companies always mention the great thing about being on the drugs but don't mention trying to come off the drugs. I guess maybe they think you'll be on it forever??
To me that makes Stablon as bad as SSRIs, valium or any other drug. They're all the same. Stablon is meant to have less side effects than SSRI. I wouldn't say so. I think it's just a milder drug. I still felt unnatural on it. Slight depersonalisation, a little too calm in some instances when maybe I should have been feeling a different emotion. However, this could be the combination of the SSRI withdrawal with a new drug that's pulling the brain in an entirely new direction from what it's become used to over the years.
Bottmom line, ultimately, you have to deal with whatever it is that's making you feel bad about life. My experience ( and this is just MY experience) is that antidepressants actually just cloud my brain and alter my mind-state to the point where I don't even know if I'm coming or going anymore. So I can't even begin to deal with the emotions I'm experiencing in a rational, level-headed way.
Just my opinion. Any others agree...?
Posted by sukarno on March 18, 2010, at 2:47:32
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by desperately seeking on April 27, 2009, at 6:31:22
Although this is an older thread, I think it's beneficial if others read it and relate their experiences with us.
I've been on tianeptine for nearly 5 years and withdrawal is even worse than it was in 2007 when I last posted in this thread.
Lowering the dose results in tension and cravings (similar to quitting smoking..almost exactly..which is quite scary), influenza-like symptoms such as you really think you are coming down with a viral illness and don't think it could be the drug. Basically body aches and feeling like crap.
There are also abnormal movements I've noticed when I was simply _late_ to take a dose. Heh.. nice. Thanks Stablon.
Then the dizziness and nausea. The worst of it is the rebound depression and increased anxiety. I suppose taking benzodiazepines would be helpful for the short term in getting through the withdrawal.
It is not as bad as SSRI withdrawal and the withdrawal is different in character, but probably that is because this drug is weaker or because it affects dopamine in addition to serotonin.
Remember, this drug has probably the shortest half-life of any antidepressant on the market: Generally 2.5 hours...
I've had brain zaps in the past when trying to withdraw but usually that didn't happen until I was down to only 1 tablet a day. That was in 2005 though and when it happened it was rather frightening and disturbing to say the least. I would say it is like a dull zap.. not a sharp or audible zap as with Paxil, for example.
The cravings are pretty intense. That might make it hard for you to stop, but since withdrawal symptoms (especially psychological withdrawal symptoms) vary from person to person, there is hope it may be easier for you to stop.
I would recommend not tapering like I did. I tapered at the rate of 1 tablet a week. I am not patient when it comes to tapering as I like to get it over with, but if I had the guts/balls to taper it again, I would try reducing the total dosage by only one-half tablet every 2 weeks or every month.
Please share your tianeptine withdrawal stories, both good and positive here. I would be very interested in hearing all about it.
Take care.
Sukarno
Posted by sukarno on March 18, 2010, at 3:02:14
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on March 18, 2010, at 2:47:32
I wonder why Servier, or another company for that matter, doesn't try to market an extended release formulation of tianeptine.
Servier could extend their patent if they did that and patients might respond a lot better.
The half-life is just too short for it to have a sustained effect. I've heard from at least one other person that it has a "see-saw" effect. It leaves the body too quickly.
Paxil, for example, has a half life of about 20 hours? Stablon's half-life is only 2.5 hours by comparison.
Posted by desperately seeking on March 18, 2010, at 5:13:42
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on March 18, 2010, at 2:47:32
Thanks for sharing your experience. I wasn't on Tianeptine for as long as that...so I don't know- maybe my withdrawal was a little easier since I was only on them for a year?
I'm surprised that you were able to withdraw so swiftly. Once when I tried to come off Tianeptine for 3 days, I thought I was going to die. My head felt as if somebody was sucking the oxygen out of it and the room felt like it was closing in on me. So, after that I tapered at a rate of 1 tablet a month (i.e shaving the pill every week). I don't remember it being anything so terrible. No suicidal ideation like when I switched from the SSRIs. Maybe a few mild symptoms. I can't remember.
It's been six months since I got down to the final pill and I'm not sure what to think. I was on SSRIs before and I switched suddenly without tapering and I've had lots of problems since then, even when I was on the Tianeptine. I think my nervous system just needs a rest. But to summarize- I still very emotionally numb and apathetic. I have tingling in my legs and hands, fatigue and residual anxiety. Not to mention sexual dysfunction- which, if I'm to go by the posts on the internet, takes years to go.The depression is manageable since I've discovered the cause of it- which was really just my family relationships. I've been reading a lot of psychology books and am getting to know myself. The REAL me. Psychologists say that depression is caused by "the loss of your authentic self" and that's directly linked to whether you believe in a higher power or not. Which I do now ( now that I'm able to FEEL ANYTHING). So, off the Tianeptine I'm basically fine And now my only problems are the after affects of being on these damn brain and body damaging drugs. Hope this helps...?
Posted by sukarno on March 18, 2010, at 9:37:56
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by desperately seeking on March 18, 2010, at 5:13:42
Sorry to hear about your experience with tianeptine. It's too bad the drug company didn't let us know in advance that some folks might have difficult withdrawal symptoms. I'm sure they must have seen this in the clinical trials back in the 1980s.
For sexual dysfunction, have you tried a dopamine agonist such as ropinirole (Requip) or pramipexole (Mirapex)? I've heard of some psychiatrists using that or bupropion (Wellbutrin/Zyban/Aplenzin) to help restore (some) sexual function.
There is a support group on Yahoo named "SSRI Sex" for those with what appears to be either long-term or permanent sexual dysfunction related to past SSRI use. They are of the thinking that long-term SSRI use may cause changes in gene expression. I'm not sure that it is permanent. It might just take some months or years to come back.
It's also possible that the body just gets used to SSRIs increasing the amount of serotonin that when withdrawn, the body doesn't immediately respond by producing enough serotonin again. Low serotonin levels can also cause sexual dysfunction, although I do know that SSRIs increase by up to 50% the number of dopamine transporters after 4 weeks of use. Dopamine then drops and that will definitely cause sexual dysfunction, apathy, emotional blunting, weight gain and lack of motivation.
I hope tianeptine doesn't do this too. It's said to not do that. In fact, if I take more tianeptine than usual, my libido sometimes increases briefly, but over the long term it seems that my libido keeps dropping. It is almost nonexistent now and I'm not even 40 years of age yet.Maybe it is my age? I have also read that low cholesterol levels can be problematic since cholesterol is involved in the synthesis of sex hormones. Low cholesterol is also linked with depression and even aggression. Someone told me that cholesterol is a precursor to Vitamin D and most folks just don't get enough Vitamin D.
I should probably have my Vitamin D, cholesterol, prolactin and testosterone levels checked.
The members of the SSRI Sex group have often reported having low testosterone lab results or high prolactin.
Posted by desperately seeking on March 21, 2010, at 13:43:41
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on March 18, 2010, at 9:37:56
Thanks for all the info. Its great to know that theyre other people like you out there going through the same thing. Yeah, the libido thing for me is a real blow - and for a lot of other people, Im sure. Frankly, the fact that theres a support group for it to me is really frightening! The problem is its so complex and dependent on so many things, including your individual biochemistry. Its even more disturbing to find that scientists dont even know what exactly happens in a persons brain when they orgasm. And different people keep saying different things e.g changes in gene expression can be reversed. So its so frustrating and confusing trying to sort this mess out.While I was on Tianeptine, I did feel more horny. Thats actually the reason why I started it after I stopped SSRIs- to see if I could counter the SSRI sexual dysfunction, though Im not sure if it works that way. It was marketed as a drug that helps depression without the sexual side affects. In fact, it was said to boost libido because it works by metabolizing serotonin quickly therefore increasing dopamine or something like that. But I have to say- I had some weird things happen to me while on Tianeptine- like clitorism a.k.a priapism (female prolonged erection). And it WASNT FUNNY. Also, on Tianeptine I could always feel horny and aroused to point of climax, but still the orgasm was weird- really abrupt, practically non-existent and completely pleasure-less. So either way, I dont think I gained much from Tianeptine in that department.I suspect thtat tianeptine does the same thing as SSRIs after long-term use. Maybe your body gets used to the artifical production of dopamine so after you stop it needs to get used to producing its own?
Im relatively young (26) and fit- so Im not sure it would be caused by low cholesterol. Im also already getting quite a bit of vitamin D. Thanks for the recommendation, but Im not going to touch another pharmaceutical drug in this life time! Im through. Everythings going to be natural from now on, including exercise, supplements, herbs, acupuncture, whatever. Im taking zinc supplements which I hear increases testosterone levels and thus sexual function (hence why oysters are aphrodisiacs since theyre high in zinc).It sounds like youre on the right track getting those tests done. Especially prolactin which I hear prevents proper orgasm when levels are too high in the body- which is what long-term use of SSRIs do apparently. I doubt very much its your age
Posted by sukarno on March 21, 2010, at 22:17:46
In reply to Re: Tianeptine (Stablon) withdrawal symptoms, posted by sukarno on March 18, 2010, at 2:47:32
I lowered my Stablon dose from 5 to 4 tablets a day on Friday and the day after I did that (Saturday) I remember I was at the refrigerator preparing some food and the room felt like it was moving around. It wasn't quite like vertigo, but I felt quite weak and the sense of up and down was a bit off for a moment. I walked back to my bedroom and felt weak and anxious like I might have a panic attack, but thankfully I didn't.
Anyway, it is Monday morning here at 10:00 and I've been fine since Sunday. In fact, I went out yesterday to visit the neighbours for the first time since last June (I was a hermit during that time because of fear of contracting H1N1... I managed to avoid it...I hope!). I felt so much better after going out and sitting at the neighbour's house. I was taking lots of pictures... shot a whole roll of film (36 exp) with my SLR. Photography is quite anxiolytic and antidepressive too. :-) I suppose it is because you are focused (pardon the pun) on something else, so you don't have time to think about anxiety.
I feel okay now. I am still using my light therapy for 2 hours a day. My wife and I also had a friend come over to visit.
Perhaps withdrawal is much easier when your mind is on other things, especially pleasurable things like going out and socialising with others.
Thank God that H1N1 is over (at least I hope). I was terribly worried for months and was excessive with regards to my hygiene. My wife wore a mask every time she went out. I feel like I wasted a year of my life just to avoid a virus, but then again I have asthma and usually get sick easily (and bronchitis), so it was best to avoid it. I'm allergic to eggs so I can't get the H1N1 vaccine.
I hope I can say good riddance to tianeptine by June or even April. Since I'm so determined, I'll try to taper by one tablet per 7 to 10 days and keep you updated on what happens.
Take care! :-)
Posted by sukarno on March 21, 2010, at 22:32:55
In reply to Day three of tianeptine taper, posted by sukarno on March 21, 2010, at 22:17:46
I also managed to quit caffeine (three cups of strong Lipton black tea a day). I lowered the caffeine by going to 2 1/2 cups for one day, then 2 cups a day for a few days... then one cup for 2 days and this morning I decided no more.
No headache (yet) and it's been 24 hours since I last had a cup. Cravings, yes. Arrgghh..! :-D
I hope I'll feel better. I tried going cold turkey two months ago and it was disastrous. The headache lasted 9 days and resolved. I thought withdrawal was over, but then I felt extremely sleepy, sleeping up to 16 hours a day and also felt a bit cold and _extremely depressed_. Oh my God, that was awful... worse than going off Stablon.
This time tapering helped. Caffeine is definitely not good for someone with panic disorder. I initiated that dumb habit last year to increase motivation as I always feel apathetic and have almost no sex drive. It immediately helped with motivation and seemed to augment Stablon, but pooped out after a few days, so it was not worth it.
I'll have to find other ways of boosting my motivation.
The human brain will always find ways of downregulating/upregulating/adjusting to any drug we take, so my feeling is that most psychiatric drugs and stimulants like caffeine are only temporary in their ability to help some recover from any given illness.
I hope because it was easy to kick the caffeine habit that I will be able to kick tianeptine too.
Posted by desperately seeking on March 22, 2010, at 16:04:55
In reply to Day three of tianeptine taper, posted by sukarno on March 21, 2010, at 22:17:46
...hey, just a quick word of caution. Don't go too quick! Cut it in half every 7-10 days if you have to to until you get down to say 3 tablets. Then shave it every few days. My experience is that the rebound 3 months down the line is a lot worse when you go down too quickly.About quitting caffeine- it's a shame because a cup of strong black to tea is said to have as many anti-oxidants as a serving of spinach and strawberries. So, drinking tea is just as beneficial for the brain and the protection of neurotransmitters which is important when you're coming off an antidepressant. And de-caffeinated doesn't have the same effects.But anyway, if you say caffeine is bad for your anxiety, so be it. Maybe very high doses of vitamin C for energy might be helpful in your case. Also, an anti-oxidant called Coenzyme Q10 which athletes are said to use to give them a boost.
Anyways, keep up the morale...
Posted by sukarno on March 23, 2010, at 5:09:19
In reply to Re: Day three of tianeptine taper, posted by desperately seeking on March 22, 2010, at 16:04:55
That sounds scary... rebound three months later? I guess it causes some sort of semi-permanent change to the brain (probably in the dopamine system as well as in the serotonin system).
I thought I was in the clear from caffeine. At least 48 hours had passed since I quit and I started getting a throbbing headache along with nausea and feeling like I want to puke. So, I'm on my second cup of tea right now, which is helping a lot with the headache and somewhat with the nausea...but it's still there.
Yeah, you're right. Too bad about having to give up tea since it is full of antioxidants. When I had the flu and drank tea it made me feel less achy, presumably due to the anti-inflammatory substances in tea.
Maybe I can have just one cup instead and see how my anxiety is. If I'm okay with one cup (instead of three previously), then I guess I should stick with that. Apart from that I eat pretty well.. red beans, green beans, rice, tomatoes and extra virgin olive oil. Maybe I can try spinach to help make up for the difference.
Posted by desperately seeking on March 24, 2010, at 11:22:36
In reply to Re: Day three of tianeptine taper » desperately seeking, posted by sukarno on March 23, 2010, at 5:09:19
Yeah, I think 3 months is the time it takes for your brain to realize that something's different. There's a really good article on coming off any antidepressants. It says the first 3-18 months are the most unstable. But to get through them, basically:-alkalanize your system (avocados, tomatoes, green veg etc. No spicy, acidic foods)
-don't use any artifical supplements (vitamins, st. john's wort etc)
-no caffeine or sugar (like what you're doing)
- rest your nervous system (no vigorous excercise, scary movies, loud noises, bright lights etc)Hope this helps...
Posted by sukarno on April 1, 2010, at 16:07:21
In reply to Re: Day three of tianeptine taper, posted by desperately seeking on March 24, 2010, at 11:22:36
This is the third day of being on only 12.5mg TID.
The first thing I noticed when decreasing from 4 tablets to three tablets was a feeling of nervousness/jitters, so I had to take Valium and it helped somewhat.Now I have a headache and yesterday had some heart palpitations that scared me. I guess my anxiety is cranked up a bit high, but not to the point of being unbearable. More strange dreams at night, but no trouble sleeping (Valium does a pretty good job at keeping me asleep.. 8 to 10 hours).
There is a dysphoria, but I increased my lightbox use from 2 hours/day to 3 hours/day and that helps a lot to offset that.
I'm holding on Valium 5mg QID until I get off Stablon, which I hope to discontinue at the end of April. If I have to, I will use more Valium temporarily to deal with any emergent withdrawal symptoms from Stablon.
It really is too bad that most psychiatric drugs cause physical dependence to one degree or another. :-(
This is the end of the thread.
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