3 replies to this topic

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*before anything, know that I will give each drug a 1-month solo, fair trial before any ragequits or augmentation* 

 

The problem: anhedonic depression, cognitive impairment (working memory, visual-spatial ability, concentration)

 

Psych drug history: absolutely NOTHING at all: no antidepressants, stims, nootropics, and not even vitamins until now

Health history: PCOS, mild prediabetes (goes with the PCOS). I take hormonal contraceptive pills to help this disorder. I feel ~30% better on the HCP. No other non-psych drugs

 

NEW DRUG: Tianeptine. normal 12.5mg/x3 dose. Legitimate prescription. It has been 10 days since I started on full dose

 

I did not get any initial euphoria, which I take is good (as the people who have it usually lose it in a week or so). The antidepressant effect of Tianeptine is thought to be from normalizing AMPA-NMDA glutamate receptor interactions. This leads to upregulation of BDNF and nerve growth crew. Also somewhere along the line the HPA axis hyperactivity gets downregulated. 

Those two are major depression biomarkers

 

my experience on tianeptine is less than stellar so far. My sleep is a little bit worse than it already was, and the first 3-4 days I felt a little more anxious (anxiety was not a symptom of mine before). Then the most bothersome effect set it: my head feels like a marshmallow! I'm even more detached and anhedonic than normal. I don't remember events of my day because I never fully experienced them. This is a different "flavor" than my usual cognition issue, but still unpleasant. However, I do feel less physically tired.

 

These negatives seem to be an acute effect of the drug. I took zero drugs one day and suddenly the marshmallow feeling was gone, only to restart again upon continuation. 

The fact that my negative effects are acute give me hope, there could be good stuff happening long-term, that I don't feel yet.

 

***Should I stay on it for more than my month trial (even if marshmallow-head continues) just in case tianeptine really is addressing those 2 main depression biomarkers (HPA axis, neuroplasticity) in the long term ? Even if I never feel the benefit, it might just raise the possibility of a spontaneous remission or will have "loosened" a stuck screw for the next drug I try to finally unscrew***.

 

I see antidepressants as medications to reverse the disease of depression, NOT provide symptomatic relief, especially at the expense of future well-being (I'm looking at you askance, Adderall)

 

 

 

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I'd have thought people would be interested in this :/

[Phlogiston]

Hi. I'm a layperson, but I'd like to think I'm an informed lay person. I've had some history with depression and mood swings, as well as cognitive problems.

 

As you noted, the conventional wisdom about antidepressants is that sometimes much of the benefit comes not from the initial effects of the drug on the brain, but on whatever the brain does over time in reaction to those effects. That is consistent with my own experience. I have used SSRI's for many years, and a dose increase will be perceptible in some ways within a week but will not really come to fruition for a month or more. I think you are on the right track in choosing to dose for at least a month before making any changes. It is sometimes said that with antidepressants, "The [initial] side effects prove that they're working."

 

If Tianeptine really addresses both your mood and congnitive issues, you're very fortunate. I have always had cognitive / brain fog issues, and SSRIs have been a two-edged sword for me in that they suppress my baseline depressive / obsessive tendencies but make my cognition even worse. I have used Focalin [dexmethylphenidate] for cognitive issues for years with moderate success.

 

Recently, advancing age and an extremely brain-unfriendly lifestyle (now discontinued) exacerbated my cognitive issues to the point of my being diagnosed with Mild Cognitive Impairment. I am now practicing the MEND protocol (Metabolic Enhancement against Neurodegeneration) suggested by the Memory Disorders Clinic at UCLA Medical School. I have attached a copy of this, along with a simplified "cheat sheet" explaining the basics.  It calls for daily cardiovascular exercise, along with dietary modifications and heavy supplementation.

 

When I really hit the rocks with my cognitive issues, I was doing everything wrong from a brain health perspective: Overweight, overmedicated, yanking my sleep schedule around with night shifts  and intercontinental travel, eating mostly sugar and starches, and doing no cardiovascular exercise. Since I have been following this protocol I have lost 25 pounds, which has enabled me to discontinue blood pressure medication that was known to have negative cognitive effects. The antidepressant effects of all the cardio and neuro-supps have enabled me to discontinue Wellbutrin, reduce my dose of Focalin and minimize my SSRI dosage.

 

My memory has improved, although I don't know what the ultimate outcome will be. The individual supplements recommended as part of this protocol are all discussed at length in various threads here at Longecity. Parts of this protocol might be very useful to you if you want to work on underlying brain health rather than symptomatic relief.

 

Attached Files

•  REVERSING MEMORY LOSS.pdf   794.33KB   6 downloads
•  Bredesen%20May%202015-2 (1).pdf   1.96MB   5 downloads

[Shai Hulud]

Stay on it for at least 6-8 weeks. If your problems are not better by then, try another AD. If it does help partly, combine it with another DA.
Tianeptine can be combined with most ADs, if not even all