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BDD Moderators: Keif’ Richards | negrogesic
Tramadol + tianeptine
- Thread starter Kudos
- Start date
effie
Bluelight Crew
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- Feb 9, 2010
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Interesting interaction question - how much tramadol and tianeptine are we talking about here?
I don't know about synergistic, but there is potential for a bad reaction if you take both drugs (although it is really uncertain how high the risk is and if it even exists...)
Firstly tramadol is known for having the potential to cause seizures, especially at high doses.. although there has been a report on here of someone having a seizure after just 300mg. 400mg is the generally accepted safe max in 24 hours, but people clearly vary greatly in their seizure potential. The risk is increased hugely if it is taken with other drugs which might lower the seizure threshold (lowering the threshold makes seizures more likely.)
Tianeptine is a tricyclic antidepression, and tricyclics can indeed lower the seizure threshold - however after doing some reading it seems that the risk is a lot lower with tianeptine than for other tricyclic antideprssants, and it is suggested as a good choice of antidepressant in epileptics! There is quite a lot of conflicting information out there - I would say there is potential for a bad interaction, but then again this research found that tianeptine actually delayed the onset of seizures in mice and may be protective against seizures. Given all of this uncertainty, it's impossible to say what the risk is - but I am a very cautious person, and don't really combine tramadol with anything at all, just in case, let alone a tricyclic antideprssant.
Secondly, tramadol is a funny drug and has some serotinergic action as well as opioid action, and tianeptine may also have some serotinergic activity, although as with it's effect on seizure threshold this isn't certain (and it may actually decrease serotonin levels as opposed to other antidepressants..)
If it is serotinergic (causes release of serotonin), then taking two serotinergic drugs together has the risk of causing "Serotonin Syndrome" which is rare but can be fatal - I have known a few people who got this comining tramadol with other serotonin releasing drugs, but no idea how big the risk is here (or even if there is one.. )
Essentially, tramadol is a tricky drug to safely combine with a lot of things, and tianeptine is an unusual antidepressant compared to the other tricyclics and SSRIs and is not very commonly known about - so although it may well be perfectly safe, I suspect it will be difficult for anyone to tell you definitely.
I used to take amitriptyline, another tricyclic antidepressant, and didn't notice any synergy with opiates, incidentally.. no experience with tianeptine however.
I don't know about synergistic, but there is potential for a bad reaction if you take both drugs (although it is really uncertain how high the risk is and if it even exists...)
Firstly tramadol is known for having the potential to cause seizures, especially at high doses.. although there has been a report on here of someone having a seizure after just 300mg. 400mg is the generally accepted safe max in 24 hours, but people clearly vary greatly in their seizure potential. The risk is increased hugely if it is taken with other drugs which might lower the seizure threshold (lowering the threshold makes seizures more likely.)
Tianeptine is a tricyclic antidepression, and tricyclics can indeed lower the seizure threshold - however after doing some reading it seems that the risk is a lot lower with tianeptine than for other tricyclic antideprssants, and it is suggested as a good choice of antidepressant in epileptics! There is quite a lot of conflicting information out there - I would say there is potential for a bad interaction, but then again this research found that tianeptine actually delayed the onset of seizures in mice and may be protective against seizures. Given all of this uncertainty, it's impossible to say what the risk is - but I am a very cautious person, and don't really combine tramadol with anything at all, just in case, let alone a tricyclic antideprssant.
Secondly, tramadol is a funny drug and has some serotinergic action as well as opioid action, and tianeptine may also have some serotinergic activity, although as with it's effect on seizure threshold this isn't certain (and it may actually decrease serotonin levels as opposed to other antidepressants..)
If it is serotinergic (causes release of serotonin), then taking two serotinergic drugs together has the risk of causing "Serotonin Syndrome" which is rare but can be fatal - I have known a few people who got this comining tramadol with other serotonin releasing drugs, but no idea how big the risk is here (or even if there is one.. )
Essentially, tramadol is a tricky drug to safely combine with a lot of things, and tianeptine is an unusual antidepressant compared to the other tricyclics and SSRIs and is not very commonly known about - so although it may well be perfectly safe, I suspect it will be difficult for anyone to tell you definitely.
I used to take amitriptyline, another tricyclic antidepressant, and didn't notice any synergy with opiates, incidentally.. no experience with tianeptine however.
synergistic.affect
Greenlighter
- Joined
- Feb 13, 2009
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- 33
I'm fairly certain tianeptine is not a tricyclic. It has structural similarities to tricyclics, but it's mechanism of action is completely different, as are it's effects profile and side effects. It is very unique, actually the only one of it's kind as far as i know (the closest relative being amineptine, which has a significant difference in dopaminergic activity.
I have personally mixed up to 400mgs of tramadol at once along with one of my tianeptine doses (been on tianeptine for 3 months, 1 tab 3x - 4x/day) and personally felt no effects, HOWEVER, i am also on low-dose buprenorphine daily and with the wacky pharmacology of tramadol, it is very possible that it's serotonergic effects (which are acheived indirectly, very possibly through some aspect of it's opiate action) are also blocked by the suboxone. The only other time i mixed tramadol and tianeptine without suboxone, i was on other opiates, again confounding any inferences i could make about a tramadol/tianeptine interaction. That said, i couldn't detect any effect from the tramadol.
There certainly has been some conflicting data, but if you follow the dates of the data, there is a progression of knowledge aquisition regarding tianeptines effects and pharmacology. I have plenty of personal experience, the actual stablon package insert, and more to discuss regarding stablon, but i will try to find the appropriate thread.
Tramadol which i
Have take
For 8 years is a SRA. Where as tianeptine is a SSRE and supposedly cancels prozacs effects a ssri Tianeptine has agonist activity at D2 D3. NMDA antagonist activity as well as its 5-ht action but has no affinity for NA transporters so there is synergy on many levels.... Put it this way if you think trams pharmalogic profile is complicated. Tianeptine even increases growth hormone secretion amongst other various actions. I love dirty compounds!'
Have take
For 8 years is a SRA. Where as tianeptine is a SSRE and supposedly cancels prozacs effects a ssri Tianeptine has agonist activity at D2 D3. NMDA antagonist activity as well as its 5-ht action but has no affinity for NA transporters so there is synergy on many levels.... Put it this way if you think trams pharmalogic profile is complicated. Tianeptine even increases growth hormone secretion amongst other various actions. I love dirty compounds!'
Lady Codone
Bluelighter
- Joined
- Mar 6, 2008
- Messages
- 2,132
I'd be very careful. Tramadol itself is unpredictable since it acts as a serotonin releaser, norepinephrine reuptake inhibitor and opiate. I honestly don't think we know enough about the brain or these two meds to say for certain whether it's a safe combo for most people.
Only useful advice: Start very low.
Edit -- woops, old thread.
Only useful advice: Start very low.
Edit -- woops, old thread.
muie
Bluelighter
- Joined
- Dec 18, 2008
- Messages
- 849
1. Would it be safe to take it with o-desomethyltramadol (M1) since it only retains the norepinephrine effects?
2. What about taking it with methadone?
I've read that clonidine should not be taken with tricyclic antidepressants (mirtazapine for example)....however like others pointed out, tianeptine has a pretty unique profile!
What is the main theory here? That tianeptine enhances serotonin while the others may block its re-uptake, therefore............??? Would they cancel each other? Produce cumulative effects? Or be extremely dangerous due to risk of serotonin syndrome?
This thread shouldn't be closed until we have a definitive answer! Also, I'm sure someone has tried this combo! I love to see old threads like this, instead of opening up another thread there is a reason people tell you to use the fucking search engine, that is because it has probably been asked before in a page like this & it has never been answered. Others hate to see this - since its an old thread, my question to those of you who don't like to see this: why does it make a difference if the post is old or new, as long as it hasn't been answered, it shouldn't make any difference when the question was asked!
p.s. nAON do you have anything to say about this or did you just pop in to stick out your tongue?
or are those just some of the privileges that come with being part of the crew? lol
2. What about taking it with methadone?
I've read that clonidine should not be taken with tricyclic antidepressants (mirtazapine for example)....however like others pointed out, tianeptine has a pretty unique profile!
What is the main theory here? That tianeptine enhances serotonin while the others may block its re-uptake, therefore............??? Would they cancel each other? Produce cumulative effects? Or be extremely dangerous due to risk of serotonin syndrome?
This thread shouldn't be closed until we have a definitive answer! Also, I'm sure someone has tried this combo! I love to see old threads like this, instead of opening up another thread there is a reason people tell you to use the fucking search engine, that is because it has probably been asked before in a page like this & it has never been answered. Others hate to see this - since its an old thread, my question to those of you who don't like to see this: why does it make a difference if the post is old or new, as long as it hasn't been answered, it shouldn't make any difference when the question was asked!
p.s. nAON do you have anything to say about this or did you just pop in to stick out your tongue?
or are those just some of the privileges that come with being part of the crew? lol
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