Misc tianeptine -- dosing, sodium/sulfate, in combo w/ SSRI

[tightlywound]

I am interested in tianeptine for treatment resistant depression and anxiety. my psychiatrist is at the point where he doesn't know what to do and has given me full support to add in tianeptine purchased online. according to him I should be able to mix it w/ my SSRI brintellix (vortiofexine) as long as I don't go overboard, but he doesn't know much about it honestly so I thought I'd check here.
what dose would be a good therapeutic starting point given that I am on 10mg vortiofexine a day?
is the sulfate or sodium form considered preferable?

<snip>

 

[kleinerkiffer]

Maybe start with 12.5mg a day and increase to the recommended 37.5 over a week if you don't feel any side effects
I found this:http://www.ncbi.nlm.nih.gov/pubmed/23683152

AIMS:
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.

 

[Znegative]

I agree with kleinerkiffer, about the dose. Does tianeptine really effect seretonin? I know it's supposed to but from my (limited) experience it acted like a pretty typical opioid, kind of like oxycodone. I've also read that IV'd it's pretty much indistinguishable from heroin.

 

[tightlywound]

I agree with kleinerkiffer, about the dose. Does tianeptine really effect seretonin? I know it's supposed to but from my (limited) experience it acted like a pretty typical opioid, kind of like oxycodone. I've also read that IV'd it's pretty much indistinguishable from heroin.

well I believe it's technically a tricyclic (albeit a unique one) so theoretically it would. I haven't done extensive research yet though.

thanks for the advice guys.

 

[tightlywound]

sodium or sulfate?