LONGECITY

Hello, I know that at first look combining a pseudo-SSRE and a SSRI seems quite a bit crazy or just irrelevant, but as last information pointed out that the mechanism of stablon (tianeptine) could be majorly via the glutaminergic system and that SSRI's or at least some of them are really not so efficious to treat anxiety combining at first like a adjuct some stablon to prozac for example would be a nice add to counteract the possible increased anxiety.

The goal of this study was to assess the efficacy and tolerability of tianeptine in combination with selective serotonin re-uptake inhibitor (SSRI) in partial responders or non-responders to SSRI monotherapy

METHODS:

In this prospective, open-label, 6-week study, 150 patients with major depressive disorder who had previously not responded or partially responded to SSRI monotherapy were recruited. Tianeptine was given in combination with an SSRI for 6 weeks.

RESULTS:

Significant improvements were observed in the mean scores of the Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS), and Clinical Global Impression-Severity (CGI-S). The change in the mean HDRS, MADRS, and CGI-S scores was significant from week 1. The response rates were 64.7% (HDRS) and 68.7% (MADRS), and the remission rates were 34.0% (HDRS) and 42.0% (MADRS) at week 6. Thirty-six patients (24.0%) reported adverse events that were determined by the investigator to be related to one of the study drugs. The tianeptine and SSRI combination was generally well-tolerated.

CONCLUSIONS:

A combination strategy with tianeptine may be an effective and well-tolerated tool for patients who have failed to adequately respond to SSRI monotherapy.

To be honest I'm not so confident in this combo but this study seems to clearly point a benefits from it. Maybe finally an addon of coluracetam would be the final touch since I had very powerfull results from the Colu/Tianep combo, though last time I have tried it didn't work. 

Tell me what you think about that.

I've used tianeptine in combination with an SNRI and in combination with tetracyclic and tricyclic antidepressants with good results. I think it would be relatively low risk for you to try tianeptine/coluracetam/prozac combination. If you've used prozac without issue and already tried tianeptine/coluracetam combination, can't see any problem with all 3 combined.