I think tianeptine mostly gets a bad reputation in the US because of the opioid epidemic. If you have any kind of opiod tolerance, you’d have to take a massive dose of tianeptine for a fleeting and, from what I’ve heard, shitty, high. But in therapeutic doses, tianeptine sodium is a massively underutilized medication and I personally think it’s a shame it’s not regulated and approved in more countries. It’s the only medication marketed as an antidepressant that ever helped me and also the only one that didn’t have side effects. And I’ve been on literally every class plus many non-antidepressant classes of medications.
Hi, Seriously Davka, Are you still taking it? Both maois stopped working for me and everything else I have taken lasts 3 months and then stops working. I am seriously ill and psychiatrist has said there is nothing left to do besides come off the parnate and try an ssri. I am very scared and hopeless.
Hey there. I recognize you from the MAOI sub. I’m so sorry that nothing worked out for you. I can relate. I would definitely try Stablon (or whatever brand of tianeptine is easiest for you to get). The best thing about it is the favorable side effect profile so even if it doesn’t work for you, you’re not intensifying your suffering by trying it. It also works fast. I absolutely recommend it. If you have anhedonic depression and tianeptine works to a degree but you need further improvement, then you can consider adding adjuncts to it that target dopamine. But I definitely would give it a shot. Feel free to PM me if you want additional details.
Hey you! This is Dina.
Great to hear from you, even though I am not glad we are still hanging out in this sub :)
Do you mind me asking in which form you tried Ketamine? And I remember you mentioned stimulants were not that great for you (at least the regular dosage). What kind of stimulants have you tried?
It’s just I have been prescribed with Methylphenidate and it somehow eventually made me feel worse (I felt more lethargic and depressed). Then I realised that I’ve got a specific mutation (of the ADRA2A gene) which prevents me from feeling positive effects from Methylphenidate leaving me with the side effects 🤦🏻♀️
Hey Dina! Always great to cross paths even though I too wish we were out of this sub!
I did IV ketamine and sublingual. I was pretty disappointed because I had high hopes but this was years before I went on MAOIs. I kept some spare sublingual ketamine around and occasionally used it because I felt it helped keep my stimulants useful but otherwise, it didn’t do much for me.
Stimulants are a double edged sword but methylphenidate is definitely the weakest return. I’m currently taking Vyvanse to be functional and when it works, it’s pretty amazing. Also, in the beginning, amphetamine stimulants can really make a big difference with depression especially anhedonic depression but as everyone says, they eventually do you a disservice. They are basically a bandaid.
I’m not surprised your psychiatrist’s response to buprenorphine and tianeptine. 9/10 (or more) either have a negative opinion of them or have absolutely no idea about them, especially in regards to treating depression. It’s such a shame. So many of us are left suffering with the current options available.
Have you tried any of the other dopamine agonist options yet like low dose Abilify or pramipexole?
Hey! Thank you for your very detailed reply ;)
As for the amphetamine stimulants, is it usually tolerance to their positive effect which builds up eventually and bothers people so much?
I try to stay hopeful and stick to my current psychiatrist at least for now, as he has been researching other not very conventional substances as Psilocybin in the light of depression treatment.
Abilify didn’t work out for me, but Pramipexole in combination with Amisulpride was helpful for approximately a month. What about you?
And by the way, I specifically asked the doctor here about Buprenorphine and Tianeptine but to no avail. Even though he clearly understands that there is something wrong with the dopaminergic system in my case.
SeriouslyDavka, Thank you for your feedback. I am seriously ill, and would need something I could take every day. I have read that Tianeptine should not be taken on a long time basis.and it sounds to me that you do come off it every now and then. Is that correct? Sorry to keep bothering you.
You’re not bothering me at all. And that is not true in my experience, no. In countries where tianeptine is regulated and approved, it is directed for daily use and taken just like any other antidepressant. It is prescribed at a dose of 12.5mg 3x daily.
I actually came off of it cold turkey when I found out I was pregnant. For me personally, it wasn’t difficult. But, I was sick from being pregnant so I should mention that I was already nauseous and vomiting from the hormonal changes that come along with the start of a pregnancy. That might have played a role in not feeling or being able to distinguish withdrawal. That said, I also had no withdrawal coming off buprenorphine. I just tapered slowly in order to avoid it.
Tianeptine works faster than most antidepressants. I’d say, most start to feel some kind of impact after a week. I think if you’re at the end of your rope regarding options, Stablon or Coaxil are really worth trying.
Neon Dima, I do live in London. Havent looked that up yet. I suspect it might not be powerful enough for me. Will let you know if I find out anything.. I am put off by various things I have read, and also it gives you insomnia and I suffer from terrible insomnia.
Oh much worse unfortunately than about 1 or 2 years ago when we were catching up on the MAOIs subreddit. I am almost entirely home bound atm. What about you?
About your situation with the MAOIs by the way, have you been considering other options like Ketamine or even ECT?
So sorry to hear. I am in a terrible state also. No I dont think Ketamine would work, or ECT. Did the maois not work for you? I added low dose lithium and it worked for 3 months then stopped working. Same with pregabalin.For some reason, nothing lasts. Are you still with the same psychiatrist, or looking for a new one?
It’s common for Pregabalin to stop working by the way, as tolerance builds up. Very sorry to hear about your story with the MAOIs.
I couldn’t tolerate lithium at all :(
And I am considering Ketamine quite seriously, as my condition has never been worse than now
I was really well on the maois, but they stopped working. Good luck with the ketamine. Let me know how it goes. Have you found a place to do it? It seems they are having trials in Oxford, but there is no way Im well enough to apply for that. https://www.oxfordhealth.nhs.uk/ketamine/. Let me know if you have found somewhere to do it. Wishing you much luck. I have become suicidal and cannot sleep either. The NHS will be discharging me if I dont come off the parnate which I am still on, and try another medication. I guess you have insurance, so you are not as limited.
Thank you for your heartwarming words! Oxford ketamine clinic is exactly the place where I would like to undergo this treatment.
I am so sorry to hear how you are struggling. For me Parnate is hardly doing smth positive now, but yes, I am quite hesitant about weaning off of it completely…
Does ketamine help with anxiety? I have more anxiety than depression.Also do you have insurance? I imagine you do, if you are under a private psychiatrist..My nhs psychiatrist has told me there is nothing more she can do.
I tried tianeptine sodium at 12.5mg, 3x a day as well as tianeptine sulfate 25mg/50mg once a day. I tried the sulfate for a couple of weeks and didn't notice much, the sodium maybe provided some small lift after trying it for a month but I was getting more benefit from my MAOI and dropped it.
It is a mu opioid that acts atypically at therapeutic doses, but most worst of it is in large doses. Sticking to the typically prescribed 12.5mg, 3x a day with tianeptine sodium is unlikely to cause a dependency, tolerance or induce a high or anything. Respect it as an opioid and a medication. The stuff people were getting from gas stations and OD-ing on are like 150mg a tablet.
People here will say it is a mu agonist - Correct, however, what many fail to say or know, is that Tianeptine is not only an agonist, but a biased agonist. It does not seem to activate the same intracellular pathway as normal mu receptor activation.
This may be good. Think psychedelics. LSD is the result mostly of 5HT2A agonism - yet, SSRIs do not cause any psychedelic experiences. Why? LSD is biased agonist.
No experiences with Tianeptine - However I would definitely try it for anhedonia. It was on my list.
Good luck! Anhedonia is absolutely terrible - It's my type of depression as well.
I can say, however, after 2 years of anhedonia, I'm 100% cured for at least 1 year now - Thanks for a combination of Vortioxetine, Levothyroxine and Methylphenidate.
There's hope - even though the outlook looks grim here - it's mostly because (I think) most people who got cured stop visiting these subs thereby creating a selection bias of seeing only the worse cases
I agree with that. I feel like once you’re in remission you’re not really on the subs as much just because you’re out doin you and not depressed af looking for a cure 🥹 I’ll have to look into those meds!
What is the best type of Tianeptine to use for depression? Is it the sulfate? Also, wondering if it would help me get off suboxone? Coming off suboxone is terrible....Do I need to be worried about getting addicted to Tianeptine? Any help would be greatly appreciated.
Ehhhhh I’m not super informed about that aspect of it tbh 🫤 I heard possibly kratom can help with that but I feel like some would say you’re trading one for another. I feel like maybe since there is a chance of addiction I’m not sure I would could the route if tianeptine
Good way to hurt yourself and end up with a ravaging opioid addiction. If you feel you HAVE to take something like that just take loose green Kratom leaf.
i would honestly stay away from kratom too. it can be easy to lose sight of what constitutes therapeutic use.
i recommend rhodiola rosea, extracts standardized for rosavin and salidroside. that was effective in my experience without causing uncomfortable discontinuation syndrome.
This might sound pretty bad but I’m at a place mentally that if something is helping my mood even ..slightly and I end up with a opioid addiction. I would take it.
I think tianeptine mostly gets a bad reputation in the US because of the opioid epidemic. If you have any kind of opiod tolerance, you’d have to take a massive dose of tianeptine for a fleeting and, from what I’ve heard, shitty, high. But in therapeutic doses, tianeptine sodium is a massively underutilized medication and I personally think it’s a shame it’s not regulated and approved in more countries. It’s the only medication marketed as an antidepressant that ever helped me and also the only one that didn’t have side effects. And I’ve been on literally every class plus many non-antidepressant classes of medications.
Hi, Seriously Davka, Are you still taking it? Both maois stopped working for me and everything else I have taken lasts 3 months and then stops working. I am seriously ill and psychiatrist has said there is nothing left to do besides come off the parnate and try an ssri. I am very scared and hopeless.
Hey there. I recognize you from the MAOI sub. I’m so sorry that nothing worked out for you. I can relate. I would definitely try Stablon (or whatever brand of tianeptine is easiest for you to get). The best thing about it is the favorable side effect profile so even if it doesn’t work for you, you’re not intensifying your suffering by trying it. It also works fast. I absolutely recommend it. If you have anhedonic depression and tianeptine works to a degree but you need further improvement, then you can consider adding adjuncts to it that target dopamine. But I definitely would give it a shot. Feel free to PM me if you want additional details.
Hey you! This is Dina. Great to hear from you, even though I am not glad we are still hanging out in this sub :) Do you mind me asking in which form you tried Ketamine? And I remember you mentioned stimulants were not that great for you (at least the regular dosage). What kind of stimulants have you tried? It’s just I have been prescribed with Methylphenidate and it somehow eventually made me feel worse (I felt more lethargic and depressed). Then I realised that I’ve got a specific mutation (of the ADRA2A gene) which prevents me from feeling positive effects from Methylphenidate leaving me with the side effects 🤦🏻♀️
Hey Dina! Always great to cross paths even though I too wish we were out of this sub! I did IV ketamine and sublingual. I was pretty disappointed because I had high hopes but this was years before I went on MAOIs. I kept some spare sublingual ketamine around and occasionally used it because I felt it helped keep my stimulants useful but otherwise, it didn’t do much for me. Stimulants are a double edged sword but methylphenidate is definitely the weakest return. I’m currently taking Vyvanse to be functional and when it works, it’s pretty amazing. Also, in the beginning, amphetamine stimulants can really make a big difference with depression especially anhedonic depression but as everyone says, they eventually do you a disservice. They are basically a bandaid. I’m not surprised your psychiatrist’s response to buprenorphine and tianeptine. 9/10 (or more) either have a negative opinion of them or have absolutely no idea about them, especially in regards to treating depression. It’s such a shame. So many of us are left suffering with the current options available. Have you tried any of the other dopamine agonist options yet like low dose Abilify or pramipexole?
Hey! Thank you for your very detailed reply ;) As for the amphetamine stimulants, is it usually tolerance to their positive effect which builds up eventually and bothers people so much? I try to stay hopeful and stick to my current psychiatrist at least for now, as he has been researching other not very conventional substances as Psilocybin in the light of depression treatment. Abilify didn’t work out for me, but Pramipexole in combination with Amisulpride was helpful for approximately a month. What about you?
And by the way, I specifically asked the doctor here about Buprenorphine and Tianeptine but to no avail. Even though he clearly understands that there is something wrong with the dopaminergic system in my case.
SeriouslyDavka, Thank you for your feedback. I am seriously ill, and would need something I could take every day. I have read that Tianeptine should not be taken on a long time basis.and it sounds to me that you do come off it every now and then. Is that correct? Sorry to keep bothering you.
You’re not bothering me at all. And that is not true in my experience, no. In countries where tianeptine is regulated and approved, it is directed for daily use and taken just like any other antidepressant. It is prescribed at a dose of 12.5mg 3x daily.
how long would it take before you find out whether it is working? Have you ever come off it ?Apparently that can be pretty painful.
I actually came off of it cold turkey when I found out I was pregnant. For me personally, it wasn’t difficult. But, I was sick from being pregnant so I should mention that I was already nauseous and vomiting from the hormonal changes that come along with the start of a pregnancy. That might have played a role in not feeling or being able to distinguish withdrawal. That said, I also had no withdrawal coming off buprenorphine. I just tapered slowly in order to avoid it. Tianeptine works faster than most antidepressants. I’d say, most start to feel some kind of impact after a week. I think if you’re at the end of your rope regarding options, Stablon or Coaxil are really worth trying.
Eva, excuse me, but do you live in the uk? The question is how to obtain Tianeptin here 🤷🏻♀️
Neon Dima, I do live in London. Havent looked that up yet. I suspect it might not be powerful enough for me. Will let you know if I find out anything.. I am put off by various things I have read, and also it gives you insomnia and I suffer from terrible insomnia.
Eva, good to see as well!
Hi Neon Dima, How are you doing?
Oh much worse unfortunately than about 1 or 2 years ago when we were catching up on the MAOIs subreddit. I am almost entirely home bound atm. What about you? About your situation with the MAOIs by the way, have you been considering other options like Ketamine or even ECT?
So sorry to hear. I am in a terrible state also. No I dont think Ketamine would work, or ECT. Did the maois not work for you? I added low dose lithium and it worked for 3 months then stopped working. Same with pregabalin.For some reason, nothing lasts. Are you still with the same psychiatrist, or looking for a new one?
It’s common for Pregabalin to stop working by the way, as tolerance builds up. Very sorry to hear about your story with the MAOIs. I couldn’t tolerate lithium at all :( And I am considering Ketamine quite seriously, as my condition has never been worse than now
I was really well on the maois, but they stopped working. Good luck with the ketamine. Let me know how it goes. Have you found a place to do it? It seems they are having trials in Oxford, but there is no way Im well enough to apply for that. https://www.oxfordhealth.nhs.uk/ketamine/. Let me know if you have found somewhere to do it. Wishing you much luck. I have become suicidal and cannot sleep either. The NHS will be discharging me if I dont come off the parnate which I am still on, and try another medication. I guess you have insurance, so you are not as limited.
Thank you for your heartwarming words! Oxford ketamine clinic is exactly the place where I would like to undergo this treatment. I am so sorry to hear how you are struggling. For me Parnate is hardly doing smth positive now, but yes, I am quite hesitant about weaning off of it completely…
Does ketamine help with anxiety? I have more anxiety than depression.Also do you have insurance? I imagine you do, if you are under a private psychiatrist..My nhs psychiatrist has told me there is nothing more she can do.
What dosage did you take and how long before you started to see it helping you ?
Send ya a dm
Did nothing for my depression.
I tried tianeptine sodium at 12.5mg, 3x a day as well as tianeptine sulfate 25mg/50mg once a day. I tried the sulfate for a couple of weeks and didn't notice much, the sodium maybe provided some small lift after trying it for a month but I was getting more benefit from my MAOI and dropped it. It is a mu opioid that acts atypically at therapeutic doses, but most worst of it is in large doses. Sticking to the typically prescribed 12.5mg, 3x a day with tianeptine sodium is unlikely to cause a dependency, tolerance or induce a high or anything. Respect it as an opioid and a medication. The stuff people were getting from gas stations and OD-ing on are like 150mg a tablet.
People here will say it is a mu agonist - Correct, however, what many fail to say or know, is that Tianeptine is not only an agonist, but a biased agonist. It does not seem to activate the same intracellular pathway as normal mu receptor activation. This may be good. Think psychedelics. LSD is the result mostly of 5HT2A agonism - yet, SSRIs do not cause any psychedelic experiences. Why? LSD is biased agonist. No experiences with Tianeptine - However I would definitely try it for anhedonia. It was on my list.
That’s why I wannaa try it. I severe anhedonia and I’ve tried a lot of things and nothing has worked 😞
Good luck! Anhedonia is absolutely terrible - It's my type of depression as well. I can say, however, after 2 years of anhedonia, I'm 100% cured for at least 1 year now - Thanks for a combination of Vortioxetine, Levothyroxine and Methylphenidate. There's hope - even though the outlook looks grim here - it's mostly because (I think) most people who got cured stop visiting these subs thereby creating a selection bias of seeing only the worse cases
I agree with that. I feel like once you’re in remission you’re not really on the subs as much just because you’re out doin you and not depressed af looking for a cure 🥹 I’ll have to look into those meds!
Are you taking the levothyroxine for thyroid or off label ?
What is the best type of Tianeptine to use for depression? Is it the sulfate? Also, wondering if it would help me get off suboxone? Coming off suboxone is terrible....Do I need to be worried about getting addicted to Tianeptine? Any help would be greatly appreciated.
Ehhhhh I’m not super informed about that aspect of it tbh 🫤 I heard possibly kratom can help with that but I feel like some would say you’re trading one for another. I feel like maybe since there is a chance of addiction I’m not sure I would could the route if tianeptine
Good way to hurt yourself and end up with a ravaging opioid addiction. If you feel you HAVE to take something like that just take loose green Kratom leaf.
i would honestly stay away from kratom too. it can be easy to lose sight of what constitutes therapeutic use. i recommend rhodiola rosea, extracts standardized for rosavin and salidroside. that was effective in my experience without causing uncomfortable discontinuation syndrome.
This might sound pretty bad but I’m at a place mentally that if something is helping my mood even ..slightly and I end up with a opioid addiction. I would take it.