Re: Stablon (Tianeptine):/dangerous

[Guest guest]

It is highly dangerous,do not take

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[Guest guest]

Why is it dangerous? Are you a real doctor?

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[Guest guest]

Stablon is not dangerous. It has been approved by the health authorities in

France, Germany, Austria, Poland, and many Asian and Latin American countries.

Well, there are side effects which can be dangerous but they are rare, such as

liver toxicity. This is thought to be an immunoallergic mechanism caused by

tianeptine breaking down into reactive metabolites. The body would attack the

reactive metabolites and then cause liver damage. There is a genetic

predisposition thought to be involved in this hepatotoxicity.

However, that is so rare and occurs usually within 30 days of beginning

treatment and is often preceded by loss of appetite, fever, nausea, rash,

itching or abdominal pain.

Its predecessor, amineptine (Survector) had the same risks, but it was still

rare.

There is also the risk of abuse and there are at least 140 cases of abuse

reported with some people taking upwards of 90 to 240 tablets per day (not sure

how they afforded that, but a lot of European countries have national health

care, so they probably saw many doctors to get multiple prescriptions and didn't

have to pay anything, or very little, for it).

Given that millions of people have taken it and only a hundred or so patients

have been identified to have abused it and that liver toxicity is very rare and

that even in large doses of hundreds of tablets a day no health problems or

blood abnormalities were observed, Stablon is a fairly benign substance.

It does produce withdrawal symptoms if discontinued abruptly or rapidly as the

half-life is only 2.5 hours, but those are nothing compared to SSRIs. I had

" brain zaps " on one occasion when rapidly tapering Stablon in 2006 or 2007 and

again this year when tapering normally (3 tablets/day for one week, 2

tablets/day for one week, 1 tablet/day for one week and then experienced a zap

which was scary).

However, the only other symptoms I had along with the one zap was difficulty

concentrating, some irritability, mild anxiety or mild nervousness, some

cravings. Felt slightly like caffeine or nicotine withdrawal, but not as bad.

The craving was the most prominent symptom, but I don't consider that a problem

as I have never continuously escalated the dosage in order to get " high " .

Financial considerations also keep me from escalating the dose, but the fact

that higher doses don't really help the depression much more than 3 to 4

tablets/day does keeps me from increasing it. I was once on 6 tablets/day and

did not experience any additional antidepressant effect.

In the long term this drug seems to gradually stop working (tolerance). The

only solution I've found is to taper gradually for a few weeks and tough it out

at 1 or 2 tablets/day, and then increase the dosage back to the standard

recommendation from Servier which is 3 tablets/day. This restores the efficacy

for a month or two. When poop-out happens again, I just taper down and repeat

that again.

This is a mild antidepressant, and I'm only speaking for myself, so it might

affect you differently. It was an amazing, and I mean *amazing* antidepressant,

in the beginning with few to no side effects... very well-tolerated, but after

being on it for a few months I had to increase the dosage from 3 tablets/day to

4 tablets/day. Being on four tablets/day is about right for me, but it does

lose its antidepressant efficacy over time, but interestingly retains its

anxiolytic efficacy.

I suppose and this is just my own hypothesis: the body might downregulate

dopamine (dopamine is thought to be the mechanism behind the antidepressant

effect besides the drug-company sponsored " neuroplasticity " theory of restoring

neuroplasticity in the hippocampus). Downregulating dopamine would result in

less antidepressant effect over time. Dopamine tends to go back to normal

levels when you stop a dopaminergic drug much more quickly than, say, serotonin.

So, you can taper down Stablon and lose the tolerance to it, so when you

increase the dose again you will feel the antidepressant effect again. This

doesn't seem to be the case with SSRIs as they affect serotonin which takes a

long time to readjust itself. Same goes with GABA.. yikes. Those two

neurotransmitters are slow to react. That's probably why SSRI and

benzodiazepine withdrawal take so long, but withdrawal from dopaminergics is

quite short in comparison.

Dopaminergics tend to poop out more quickly too. I've heard of people on

Mirapex who said it was great until 3 months later when it wouldn't work anymore

for their depression. You just have to quit for a while and then go back on it.

Conversely, with SSRIs, going back on them after a period of abstinence won't

restore efficacy in some folks as I have read.

The anxiolytic effect of Stablon is probably related to its serotonergic

profile, despite it enhancing reuptake of serotonin at the serotonin

transporter. It also affects NMDA receptors (something to do with glutamate

too). Stablon also reduces free serotonin levels and cortisol in the

bloodstream.

Reducing free serotonin improves the clinical picture of asthma as demonstrated

by pulmonologist Dr. Fuad Lechin, who practices in both Texas and Venezuela.

Sorry for the long post, but just wanted to clear up the idea that Stablon is

" dangerous " . Maybe he was thinking of liver toxicity but that is very rare. If

you take it, get your liver function checked a few times. If you get a fever or

rash and loss of appetite, see your doctor and have an immediate liver function

test. If it is abnormal, immediately stop taking Stablon.

The majority of people won't have problems, but it also seems that most people

don't respond to Stablon or don't respond well enough to justify its continued

use or expense.

I respond to it, but tolerance is a problem to the antidepressant effect.

Withdrawal's worst part is the depression coming back, which could be rebound

depression (a part of withdrawal) or relapse of the original condition for which

it was prescribed.

Stablon has no drug interactions as it is metabolized not by the P450 enzyme

system, but rather it is metabolized by beta-oxidation. It is relatively safe

in overdose and is non-cardiotoxic as far as I can tell, even in high doses,

unlike other tricyclic antidepressants.

There is no evidence that Stablon causes weight gain or sexual dysfunction.

Stablon also does not cause gastrointestinal hemorrhage which is a definite risk

with SSRI use (risk is 7 fold higher in those taking SSRIs and it happened to

me. My stomach began to bleed after 2 months on fluoxetine/Prozac).

Stablon may also be beneficial in erectile dysfunction according to a 2005

Egyptian study. Stablon may also be beneficial in asthma as evidenced by a

study of 25,000 participants (mostly children, IIRC) in whom asthma was markedly

improved after one or more doses of Stablon.

I don't work for Servier and hold no stock in the company. I wish this

medication was made by generic manufacturers.. too bad it's not!

It has been on the market since 1988.

The only side effect I get from Stablon is a very mild dry mouth (not completely

dry) and this is transient and not sustained for very long. It doesn't seem to

be dose-dependent in myself. I have experienced it after taking only 1

tablet/day and experienced nothing when on 2 tablets. It just seems to happen

at random. Other times I have felt sleepy or just apathetic and wanted to lie

down and do nothing. I had a feeling of being comfortable with life, despite

the adversity, and thought it might be an emotional blunting, but I am not sure.

It is nothing like SSRI mood blunting. Comparing SSRIs to Stablon is like

comparing candy to hard drugs. heh.

I wonder if Stablon could augment the effects of other standard antidepressants,

making them more effective and suppressing the sexual side-effects?

Regards,

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[Guest guest]

Thanks. Did it help with libido?

My main interest is the neuro-plasticity and neurogenesis.

I have a study where scientists gave mice intranasal insulin and it ameliorated

diabetic neuropathy. It showed how the mice grew new nerve cells and the placebo

mice didn't. The mice weighed 20-30gm and were sniffing 0.87iu/day of insulin.

The experiment lasted 6 months.

I did the math. A 160lb lab mouse would have to sniff 2100iu/day.

That is a lot, and very expensive. At 6 months it would cost about $30,000(I

don't have that $). So, Stablon is starting to look better.

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[Guest guest]

Hi everybody,

one correction I want do: Stablon is NOT approved in Germany (I am from

Germany).

You can also expect long-term effects on the body and I'm sure that this medical

has at least a similar risk like SSRI.

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[Guest guest]

Totally co-sign what danillo said. Stablon did to me what SSRIs did. See:

http://health.groups.yahoo.com/group/SSRIsex/message/14411.

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[Guest guest]

Oh, sorry about that. I was confused after reading studies on tianeptine

performed in Germany and a pharmacy there (maybe it's not really located there

though) selling it and some Germans saying they were taking it. Probably they

got it from an online pharmacy that took orders in Germany, but shipped from

another country.

Have any of you seen Dr Bob's Psychobabble website? A lot of folks there have

tried tianeptine. There are quite a few stories on it there. They discuss

various meds and I think a lot of them have been on SSRIs with damaged libidos.

PSSD may have been discussed there. Perhaps they can be directed here to learn

more.

http://www.dr-bob.org

I have to admit amineptine was THE best (for me), but too bad that was removed

from the market. I only have some old, crumbled tablets left. I remember

taking a small dose and then within 12 hours my mood began to improve and I woke

up with an erection, however that is a dopamine reuptake inhibitor.

I sometimes get an increased libido if I double-dose tianeptine, but not always.

I don't believe it has reduced my libido because before I took it (in 2004) my

libido was very almost nonexistant.

I'm on light therapy in addition to tianeptine. I also just bought Sifrol

(pramipexole), made by Boehringer Ingelheim (sp?). That is Mirapex (same active

ingredient).

I might try that too if light therapy doesn't do something soon.

Regards,

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[Guest guest]

If you find a doctor who gives you a prescription for stablon, then it is legal

that a pharmacy imports it (for example from France) and gives it to you. You

can do this with almost every medical. The only condition is, that it is legal

in the country from which you import it, that it is not a narcotic or illegal

drug (I mean cocaine ...) and that you have a prescription from a doctor.

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[Guest guest]

That would be a serious risk. I'd like to see comparative data between SSRI's

and Stablon. Or user feedback would be good to hear from anyone who has first

hand experience with both and can share their experience with this.

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[Guest guest]

Ok, forget the last post I wrote. I sent it before I got to read post 4c.

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[Guest guest]

Are you a real doctor?

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