Misc Tianeptine and amitriptyline

[Spurs_1882]

I take 45mg Amitriptyline at night and have done for about 8 years. I'm very tolerant to it, I can take 100mg and feel no effect, but I get WD if I try and stop it. I want to take a recreational dose of tianeptine on top of this. Just wondering how safe/dangerous this would be? Thanks.

 

[Vastness]

I can't really see why it would be dangerous, depending on what a recreational dose of tianeptine is to you. Obligatory disclaimer, I'm not a doctor, pharmacologist or medical professionals of any kind but I can't really see that these drugs have very much overlapping action.

I did a little googling out of interest before I posted in case I was overlooking something major and I found a reddit thread of someone wondering how safe this was therapeutically, some people were saying they combined them and they weren't really synergistic but almost cancelled each other out. I did find a report of a woman who ingested a massive amount of both in, possibly, a suicide attempt, like 400mg+ tianeptine, can't remember how much amitriptyline but a lot - and was successfully treated with naloxone. She had no history of opiate use and the report just reads like a fairly uncomplicated opioid overdose to me. This was from 2010 - which IIRC is maybe before tianeptine's opioid activity was widely known, which would explain why the paper is written as if they're kinda confused about what's happening.

I've seen tianeptine described as an "atypical tricyclic" and I don't know how accurate this is, and I guess would give you pause when considering mixing with another TCA, but it's certainly very atypical and does not have very many problematic interactions AFAIK and IME. It would be more accurate to consider it an atypical opioid, IMO, since the opioid activity in actual fact seems to be the most important aspect of it's activity profile with a little AMPA and BDNF weirdness mixed in (IIRC, again)... which shouldn't be much to worry about.

I'd say if you start cautiously, maybe in the 40mg range for sulphate or 25-30mg for sodium/Stablon... for me this would be just about recreational and I'd hazard a guess that twice that would probably still be in the range of relative safety... obviously you may want to adjust that depending on bodyweight, innate tolerance, and other factors... tianeptine is short acting enough though that I'd say if you start cautiously you should know within an hour or 2 at most if anything concerning is going on, and you can decide how to proceed from there...

Again though, not a doctor! I admit also not really knowing too much about tricyclics in general, so take my input with the appropriately sized grains of salt.

 

[Spurs_1882]

Thanks, that's actually really helpful and don't worry won't take what you said as complete gospel.

 

[beebs76]

I have used both together. I only take 10MG of Amitriptyline at night and take Tianeptine off and on through day. Be ready for some wild
dreams though.

 

[Smyth2]

i take 150mg amitriptyline to help me sleep some nights. I have not tried tianeptine yet.

Why would you mix the 2 together? Just try taking the tianpetine on its own.

btw 150mg amitriptyline is a massive overdosage for beginners reading this.

 

[Spurs_1882]

i take 150mg amitriptyline to help me sleep some nights. I have not tried tianeptine yet.

Why would you mix the 2 together? Just try taking the tianpetine on its own.

btw 150mg amitriptyline is a massive overdosage for beginners reading this.

Why take them together? Because I am physically dependent on amitriptyline so I need to take it to feel normal and avoid withdrawals (I've taken it for about 8 years).

 

[Spurs_1882]

I can't really see why it would be dangerous, depending on what a recreational dose of tianeptine is to you. Obligatory disclaimer, I'm not a doctor, pharmacologist or medical professionals of any kind but I can't really see that these drugs have very much overlapping action.

I did a little googling out of interest before I posted in case I was overlooking something major and I found a reddit thread of someone wondering how safe this was therapeutically, some people were saying they combined them and they weren't really synergistic but almost cancelled each other out. I did find a report of a woman who ingested a massive amount of both in, possibly, a suicide attempt, like 400mg+ tianeptine, can't remember how much amitriptyline but a lot - and was successfully treated with naloxone. She had no history of opiate use and the report just reads like a fairly uncomplicated opioid overdose to me. This was from 2010 - which IIRC is maybe before tianeptine's opioid activity was widely known, which would explain why the paper is written as if they're kinda confused about what's happening.

I've seen tianeptine described as an "atypical tricyclic" and I don't know how accurate this is, and I guess would give you pause when considering mixing with another TCA, but it's certainly very atypical and does not have very many problematic interactions AFAIK and IME. It would be more accurate to consider it an atypical opioid, IMO, since the opioid activity in actual fact seems to be the most important aspect of it's activity profile with a little AMPA and BDNF weirdness mixed in (IIRC, again)... which shouldn't be much to worry about.

I'd say if you start cautiously, maybe in the 40mg range for sulphate or 25-30mg for sodium/Stablon... for me this would be just about recreational and I'd hazard a guess that twice that would probably still be in the range of relative safety... obviously you may want to adjust that depending on bodyweight, innate tolerance, and other factors... tianeptine is short acting enough though that I'd say if you start cautiously you should know within an hour or 2 at most if anything concerning is going on, and you can decide how to proceed from there...

Again though, not a doctor! I admit also not really knowing too much about tricyclics in general, so take my input with the appropriately sized grains of salt.

I tried 37.5mg (not sure if these are sulphate or sodium, the packaging is all in German which I can't understand) and it did nothing. I wonder if this is, like you say, the two cancelling each other out, or if it's because I've got a high tolerance to TCA's due to amitriptyline use. I'm going to try 4 tablets and see if it does anything; that will be 50mg.

 

[beebs76]

Was it your first time taking Tianeptine? Ya should have felt something, especially if it were the sodium.

 

[Vastness]

I tried 37.5mg (not sure if these are sulphate or sodium, the packaging is all in German which I can't understand) and it did nothing. I wonder if this is, like you say, the two cancelling each other out, or if it's because I've got a high tolerance to TCA's due to amitriptyline use. I'm going to try 4 tablets and see if it does anything; that will be 50mg.

If they're 12.5mg they'll be Stablon, ie, sodium, AFAIK the sodium form in 12.5mg tablets is the only version ever to be approved or produced pharmaceutically, there was some limited research into the sulphate version which was for some reason abandoned, then later on it was picked up by various "nootropic" and RC-type manufacturers. Perhaps because people were starting to catch on that it wasn't in fact an "SSRE" like the original manufacturers were telling everyone but mostly just an opioid, and marketing an opioid as an antidepressant was becoming a much harder sell, post-opiate crisis...

Anyway yeah I'd think you'd definitely feel something from 37.5mg sodium usually, gotta be that the amitriptyline is blocking the effects somehow... perhaps you could push the dose a little higher but once you get into the 50-100mg range traditional opioid effects will dominate, which, IME, is really not where tianeptine shines, sodium especially is so short acting, there isn't time to appreciate any of the traditional opioid-type fun stuff, IMO, just an hour or so of extreme sedation then boom done, kinda foggy and even slightly anxious for the rest of the day... Honestly I don't even know if tianeptine has the "fun stuff" when the opioidism dominates, people do use it for that effect, there are reports on this forum of people taking huge doses, although I'm not sure if anyone has actually chosen tianeptine specifically because they like it AS AN OPIOID, rather than just because at one point it was very easily available and cheap and they were using it to manage withdrawals from more well known opioids.

If you've taken 37.5mg and not felt anything you'd probably also be fine up to 75mg total for the day, if it were me I'd maybe go to that just to feel like I'd given it a proper chance. But if you don't feel anything or feel just minor effects (or just start to feel groggy and sedated before then) it's probably safe to assume amitriptyline is just blocking any possible good stuff and this combination is probably not worth it.

IMO - even though the opioid agonism is apparently key to the AD effects of tianeptine - it is still in the "just above therapeutic" range where it really shines, therapeutic is good and a little higher IME is usually OK, but to properly appreciate it the dose needs to be below where the opioid agonism just overwhelms the other interesting atypicality that modulates the opioid stuff and prevents it from being just another uninteresting opioid.

 

[Spurs_1882]

Went up to 62.5mg. If I felt anything it was insomnia and a bit of itchiness. I may gradually go up to 100mg but not beyond, am getting the sense it's not the drug for me. (btw I don't regularly do opiates so don't think I would have a tolerance in that area, seems strange I am not getting anything from this drug).

 

[Spurs_1882]

Was it your first time taking Tianeptine? Ya should have felt something, especially if it were the sodium.

Yeah that was the first time.