*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)