![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 65 to 89 of 183. Go back in thread:
Posted by hok on May 3, 2005, at 18:23:25
In reply to Rasagiline (Azilect) useful for motivation?, posted by sukarno on May 3, 2005, at 7:27:03
anybody tried it yet? it's supposed to be like selegiline but without the amphetamine metabolites. I guess it won't be available in europe or the u.s. until later this year. I was only able to find it online through some of the pharmacies in Israel, where it was recently launched.
Posted by sukarno on May 3, 2005, at 19:07:56
In reply to Re: Rasagiline (Azilect) useful for motivation? » sukarno, posted by hok on May 3, 2005, at 18:23:25
So you can buy it from an Israeli online pharmacy? I might try that.
My interest in dopamine agonists stems from persistent lack of motivation and low libido. I don't suffer from erectile dysfunction (impotence) though, just lack of interest.
Does anyone here find dopamine agonists or dopamine reuptake inhibitors (e.g. Survector...how I wish I had that! argh!) useful for increasing libido (sex drive)?
I think Stablon may have helped, but only marginally.
A lot of people say l-deprenyl (Eldepryl/selegiline) and Dostinex (cabergoline) are great for reviving one's sex life, in addition to helping boost motivation and lift depression.
:-)
Posted by sukarno on May 3, 2005, at 23:04:40
In reply to Survector, posted by sukarno on May 1, 2005, at 3:24:03
Hi everyone.
I just called PT Darya-Varia Laboratoria, the local manufacturer of Survector and they informed me that it is no longer being produced here, so they told me to call Servier, which I just did.
Servier told me that they quit making it "a long time ago" but they have a new one called "Stablon"... that wasn't news to me.
Anyway, I went to Servier's website and they have a Parkinson's drug which boosts dopamine D2 and D3 and also norepinephrine! :-)
Sounds like a good Survector substitute I suppose, because Survector boosted dopamine and also norepinephrine and serotonin (somewhat).
This is a link to product information of Trivastal (Piribedil):http://www.servier.com/pro/Neurosciences/trivastal/trivastal_press.asp
Might be worth a shot.
Posted by ed_uk on May 5, 2005, at 6:16:15
In reply to Re: Survector expired, posted by sukarno on May 3, 2005, at 6:31:22
Hi Paul,
>How are you doing now? Are you still off medication?
I'm ok thank you, no withdrawal symptoms :-) I won't be going back on lofepramine in the near future.
>Is it difficult to get Seroxat now in the UK?
It's still prescribed a lot, some docs prescribe it like candy... others are more cautious.
>BP
If you stick to the appropriate diet, Nardil reduces blood pressure.
>I have found that Survector is still being produced in Uruguay and Brazil...
Is that definite? I thought they were just using the remaining stocks in Brazil.
Kind regards,
Ed.
Posted by sukarno on May 5, 2005, at 8:51:58
In reply to Re: Survector expired » sukarno, posted by ed_uk on May 5, 2005, at 6:16:15
Hi Ed! :-)
I've always wondered why Nardil and TCAs such as imipramine are more effective at blocking panic attacks, because SSRIs and many other drugs target the same neurotransmitters as the older MAOIs and TCAs.
Is there some mode of action that Nardil and Tofranil (imipramine) have that is separate from their effects on 5-HT and to a lesser extent NE that causes them to have much higher efficacy than the SSRIs?
I remember that imipramine was heavily sedating and that was good for me because I needed a good night's sleep after all that anxiety and panic. I've heard Nardil is not sedating though.
Tofranil is said to be the gold standard in treating panic disorder anyway (or used to be).
Survector is still being produced in Uruguay according to an online pharmacy, but I'd bet that they are wrong about it after doing more searching on Google.
I think it was forced off the market due to the SSRIs. I've never heard of a medication that was on the market for 21 years and then suddenly pulled like that.
We, the sufferers/victims of anxiety/depression, are not the ones who are considered when the big decisions are made by the top drug companies, etc.
I remember when I had told the first psychiatrist I saw here in Indonesia about my panic disorder, he ignored what I had said about my bad reactions to SSRIs and prescribed me Zoloft anyway. Of course I didn't fill it.
I'm still taking Stablon, but lowered the dose to 2 tablets a day.. headache is much improved. Is that headache caused by serotonin?
I feel quite depressed though. I'm hoping to find some antidepressant that will work and not be chock full of sexual side effects or anxiety like SSRIs or the cardiotoxicity of TCAs, etc.
I guess I'm afraid to try Nardil. What foods _can_ I eat on Nardil? I know to avoid tyramine-rich foods, but what I eat now is:baked beans, spaghetti noodles, high fiber wheat bread, olive oil.
That's my vegan diet. lol... Is that free of tyramine?
Thanks Ed. I think you are a psychopharmacologist in reality, eh? hehheh. You know your stuff about medications and mechanisms of action, etc.
Best regards,
Paul:-)
Posted by Chairman_MAO on May 5, 2005, at 16:54:45
In reply to Re: Survector expired, posted by sukarno on May 5, 2005, at 8:51:58
After approximately a three-day adjustment period where I had some mild "brain shocks" and emotional lability, the 75mg phenelzine I switched to from the 120mg tranylcypromine kicked in. Wow, I am impressed! It's a lot like the mild euphoria the parnate gave me without any of the stimulant side effects. I still do miss Parnate's DA "push" that gave me a little extra motivation and "go get em'" attitude, but I am really loving how calm I am. Also, my libido is slightly dampened, but performance and the enjoyment of "the act" are intact. Pretty nice. Now, if I don't start gaining weight exponentially, I'll be all set! My sleep is also vastly improved on phenelzine over tranylcypromine.
I really can't say enough good things about the irreversible MAOI + buprenorphine combination. I really feel someone should do a study of it in treatment-resistant depression or anxiety disorders.
That said, please don't be afraid of the diet nor the drug interactions. It's really very easy to follow. Everyone's different, but I ignore the diet except for the following, which I strictly observe:
NO:
1) Fermented Soy Products
2) REAL aged cheeses. Processed cheddar, etc. that one finds in 75%+ of all food in the USA are safe. As a matter of fact, the tyramine reaction was first discovered when MAOIs were introduced in Europe, because their aged foods are actually significantly aged, so people started having terrible headaches and stroking out all over the place. No one really noticed this in the US because most of our food is slop. ;)
3) Tap beer anywhere other than bars that I am certain clean their taps. If I'm going to a savory restaurant, especially one I frequent, I simply explain to the bartender that I am highly allergic to fermented beer residue in the taps and to simply be straight up with me about whether they clean the taps or not. It's never led me wrong yet, probably because no bartender wants to risk a lawsuit after I tell them what the reaction would be. Of course, I always carry around some chlorpromazine just in case (want to get phentolamine amps /w syringe to carry while I travel, but I dont know if doc will rx that, heh)
4) REAL air-dried sausages and aged meats
5) fava/broad beansThat's pretty much it for me. Simply avoid stuff that's really aged, spoiled, or otherwise old, and you'll do fine. You can carry medication with you to abort a hypertensive crisis, too. I think you'll find that, if you respond to an MAOI, you will never want to go back. I have ingested one or more representatives from just about every class of illicit and licit psychoactive drug, and have yet to find something that reliably produces anywhere near as course or robust a mood lift as the irreversible MAOIs. Any drug that's ever come along (at least in the US) that's ever stood a chance at rivaling the MAOIs has been taken off the market because of "abuse potential". I feel today the MAOIs would've never been FDA approved because of abuse potential, but they got in the door before the insanity convention of 1972 when they signed the CSA into law. I'm happy about that, too, because otherwise I would be a more-or-less miserable dysfunctional wreck.
Posted by ed_uk on May 6, 2005, at 5:28:39
In reply to Re: Survector expired, posted by sukarno on May 5, 2005, at 8:51:58
Hi Paul!
>Is there some mode of action that Nardil and Tofranil (imipramine) have that is separate from their effects on 5-HT and to a lesser extent NE that causes them to have much higher efficacy than the SSRIs?
Nardil raises levels of 5-HT, NE, dopamine and GABA in the brain. Parnate raises 5-HT, NE and dopamine but not GABA. Also, it is important to bear in mind that MAOIs affect 5-HT via a completely different mechanism to the SSRIs.
In addition to 5-HT reuptake inhibition, the noradrenergic properties of imipramine may help to suppress panic attacks.... SSRIs do not share this effect.
>Survector is still being produced in Uruguay according to an online pharmacy, but I'd bet that they are wrong about it after doing more searching on Google.
Can you find out who the manufacturer is, call them, and find out whether they're still making it??
Kind regards,
Ed.
Posted by pro_social_soon on May 6, 2005, at 5:40:31
In reply to Re: Survector » sukarno, posted by ed_uk on May 6, 2005, at 5:28:39
> Hi Paul!
>
> >Is there some mode of action that Nardil and Tofranil (imipramine) have that is separate from their effects on 5-HT and to a lesser extent NE that causes them to have much higher efficacy than the SSRIs?
Dr.Liebowitz observed in comparison studies between the TCA "imipramine" (Tofranil) and the MAOI "phenelzine" (Nardil) that while phenelzine was extremely effective in treating Social Anxiety, imipramine showed no efficacy - with the primary difference in the two drugs being the marked pro-DA effect of Nardil. Recent studies also show low levels of sex steroid "pregnenolone sulphate" in those with generalized Social Phobia and GAD (generalized anxiety disorder). Low PS levels are linked with abnormal dopamine function and passivity.
Posted by sukarno on May 6, 2005, at 12:16:21
In reply to Nardil,Imipramine » ed_uk, posted by pro_social_soon on May 6, 2005, at 5:40:31
Hi Ed! :-) I sent off an email a few days ago to Uruguay but have not received a reply. I even wrote it in Spanish. Oh well. *sigh* I guess it's gone for good!
" Dr.Liebowitz observed in comparison studies between the TCA "imipramine" (Tofranil) and the MAOI "phenelzine" (Nardil) that while phenelzine was extremely effective in treating Social Anxiety, imipramine showed no efficacy - with the primary difference in the two drugs being the marked pro-DA effect of Nardil. Recent studies also show low levels of sex steroid "pregnenolone sulphate" in those with generalized Social Phobia and GAD (generalized anxiety disorder). Low PS levels are linked with abnormal dopamine function and passivity."
Would this explain low libido in some folks with GAD?
I'm also interested to see if l-deprenyl (selegiline, trade name "Eldepryl" and in Indonesia "Jumex") since it is an MAO-b inhibitor in doses <10mg, could have the same effects as Nardil on panic disorder. I'm assuming it doesn't affect GABA...perhaps it is more like Parnate?
Also, DA agonists tend to lower prolactin levels which can increase libido and motivation.
I wonder if l-deprenyl is a better idea for me than Nardil. I'm afraid also of what dose I should take since all of these drugs are metabolised by CYP2D6.
I highly suspect that I'm a "poor metaboliser".
I've also considered amphetamine but it too is metabolised by 2D6.
The rule of thumb I went by with Prozac and Effexor was to take 1/20 the standard dose and that worked, except I couldn't find an Effexor elixir to take, so I took 1/4 of 25mg dose and it gave me hypertension and severe headache.
Posted by sukarno on May 6, 2005, at 14:57:57
In reply to Developing side effects to tianeptine (Stablon), posted by sukarno on March 25, 2005, at 5:30:58
Atypical antidepressants
Enclosed in 16/02/2005Until it appears a better term, the antidepressants that do not characterize as Tricíclicos, as Inhibiting Selective of the Recaptação of the Serotonina and nor as Inhibiting of the MonoAminaOxidase are atypical.
Some of these Atypical Antidepressants increase the noradrenérgica transmission, through the antagonism of receivers a2 (daily pay-sinápticos) in the central nervous system, at the same time where they modulate the central function of the serotonina for interaction with the receivers 5-ht2 and 5-ht3, as it is the case of the Mirtazapina.
The antagonistic activity in the histaminérgicos receivers H1 of the Mirtazapina is the responsible one for its sedative effect, even so is practically unprovided of anticolinérgica activity.
Other atypical ones are inhibiting of the recaptação of Serotonina and Norepinefrina, some also inhibiting, the recaptação of dopamina. It is the case of the Venlafaxina, the Mirtazapina. Some of these drugs also costumam to reduce the sensitivity of the receivers beta adrenergics, also after acute administration, what it can suggest a beginning of faster clinical effect.
Also they are here the inhibitors of the recaptação of the Norepinefrina (Noradrenalina), as it is the case of the Riboxetina. Some atypical ones, as it is the case of the Tianeptina, even so are serotoninérgicos, do not inhibit the recaptação of the Serotonina in the neuron daily pay-sináptico but, induce its recaptação for the neurons of the cortex, hipocampo and the límbico system.
The Amineptina, another atypical one, is a molecule derived from the tricíclicos but its mechanism of action is essentially dopaminérgico, while that the other tricíclicos antidepressants are essentially noradrenérgicos and serotoninérgicos. Unhappyly its production in Brazil was discontinued in 2005.
http://translate.google.com/translate?hl=en&sl=pt&u=http://virtualpsy.locaweb.com.br/index.php%3Fsec%3D61%26art%3D273&prev=/search%3Fq%3Dbrasil%2Bamineptina%26hl%3Den%26lr%3D%26sa%3DG
Posted by ed_uk on May 7, 2005, at 8:57:08
In reply to Re: Nardil,Imipramine, posted by sukarno on May 6, 2005, at 12:16:21
Hi Paul!
I'm sorry to hear about amineptine being discontinued in Brazil :-(
>selegiline.....
Selegiline can sometimes cause considerable anxiety as a side effect. I haven't heard of anyone benefitting from it as a treatment for anxiety.
Kind regards,
Ed.>
Posted by Chairman_MAO on May 7, 2005, at 12:00:08
In reply to Nardil,Imipramine » ed_uk, posted by pro_social_soon on May 6, 2005, at 5:40:31
ARe you sure the neurosteroid in question was not allopregNANolone? Pregnenolone is a negative GABA-A modulator, while allopregnanolone is a positive GABA-A modulator, acting at a binding site on the GABA-A receptor distinct from benzodiazepines and barbiturates. Interestingly enough, allopregnaolone builds cross tolerance to diazepam, but not to itself. It is also more potent than benzos. The investigational drug ganaxolone is a methylated synthetic derivative of allopregnanolone that is being studied for epilepsy, but I predict will have profound value in treating PTSD, mood disorders related to the menstrual cycle, as well as SAD, GAD, etc.
Posted by Chairman_MAO on May 7, 2005, at 12:11:17
In reply to Re: Nardil,Imipramine, posted by sukarno on May 6, 2005, at 12:16:21
Unfortunately, selegiline does not have the same magical effect (at least for me) on social anxiety that Nardil does. Perhaps somewhat motivating, but anxiety was increased. I took up to 15mg/day on top of Celexa and then Lexapro years ago. I wish I knew then what I know now, because I Would've asked my shrink then--who was extremely accomodating to my needs--to try an irreversible MAOI. I brought it up in passing, but he told me he'd rather not deal with it because of the diet unless we had to. In retrospect, if I pushed the issue, I'm sure he would've gone for it. Oh well,gotta look to the future now. :)
I have to say, now that the adjustment "brain shocks" have subsided (after only about 5 days), Nardil (75mg/day) is slightly superior to tranylcypromine (200mg/day) for social phobia. Parnate would be better for someone with absolutely no other anxiety complaints except social phobia, I think, because it has such a great dopaminergic "push" to it. At around 120mg/day and above, it is really like no other medication; I feel for anyone (like SLS) whose depression is so recalcitrant that it doesn't respond to that because it is so damn effective. However, phenelzine has somewhat of an effect like that for me, although it's more subtle. The main difference is that phenelzine is so effective for the physiological manifestations of anxiety, general anxiety, etc. that it's superior--again, for me--in social phobia. It is better than a benzo for me, because it gives me motivation instead of takes it away. I'm noticing that it makes me want to go up to people I don't know and just talk to them. I have never felt that before. Is that what it's like to be an "outgoing" person? Wow, there's a whole world out there ...
Posted by sukarno on May 20, 2005, at 3:40:04
In reply to Re: Nardil,Imipramine » sukarno, posted by Chairman_MAO on May 7, 2005, at 12:11:17
Hi everyone! :-)
Well, I've figured out that 2 tablets a day doesn't quite cut it for my depression, but 3 tablets gives me a headache and some slight jitters, so I'm going to have to "fine tune" the dose some more.
I'm guessing that 2 1/2 tablets per day is optimal dose for me.
This is good stuff...much more tolerable than an SSRI and I definitely don't worry like I used to.
:-)
I did have a major panic attack, but that was a few days after I moved to a new house, so all the moving, etc, could have caused that.My Xanax dose is 1mg at 9am, 1mg at 3pm, 1.5mg at 9pm and another 1.5mg at 3am/5am (depending on when I wake up).
5mg seems to stop the nighttime panic attacks. I'm getting more used to the weird dreams I guess. hehheh.
Posted by ed_uk on May 20, 2005, at 5:09:53
In reply to Stablon (tianeptine) update, posted by sukarno on May 20, 2005, at 3:40:04
Hi Paul!
I hope you're not having any side effects from the increased Xanax :-)
Ed.
Posted by Declan on May 20, 2005, at 7:33:11
In reply to Re: Stablon (tianeptine) update » sukarno, posted by ed_uk on May 20, 2005, at 5:09:53
Hi there, so its worth taking, you reckon? Like it's one I can actually get . Does it help you get organized and motivated at all?
Declan
Posted by sukarno on May 20, 2005, at 8:09:17
In reply to Re: Stablon (tianeptine) update, posted by Declan on May 20, 2005, at 7:33:11
Hi Declan. :-)
I find it helps me concentrate better or think clearer. I don't really feel more motivated unfortunately.
I was thinking of trying dopamine agonists like Survector *grin* or some of those Parkinson's drugs since they seem to really boost motivation from what I've read.
Other than that, I've read that amphetamines like Adderall are good for lack of motivation, but they have quite a few side effects and would probably worsen my anxiety. Not sure if the benzos would cover for the anxiety caused by amphetamines.
The price of Stablon is quite high I think, especially since you have to take it 2 to 3 times a day. Here in Jakarta it is about 40 to 60 cents per tablet...so multiply that by 2 or 3 and the cost is substantial, but to me it is worth it...and I don't have insurance so I pay the full price.
Maybe in a larger dose it will motivate you. I like the good feeling it gives me in the higher doses, but I'll end up with a headache later on. Gives me some jitters but not as bad as caffeine or anything of that sort. Feels like adrenaline and my breathing improves.
It has been investigated in treatment of asthma and the few studies I've read are promising, so if you have asthma you might want to give it a try.
I took 3 yesterday and feel pretty good now...not depressed at all.
No side effects from increasing the Xanax to 5mg/day. My doctor said it was ok to do that.
One thing about Stablon I've noticed is that it has reversed some of the cognitive deficits caused by Xanax and/or anxiety. I feel "smarter" than I used to.
Posted by sukarno on May 25, 2005, at 6:56:53
In reply to Developing side effects to tianeptine (Stablon), posted by sukarno on March 25, 2005, at 5:30:58
I ran out of Stablon a few days ago and had to resort to taking an expired batch (exp. 1/2004) which I got as a free sample from a pdoc in 2002.
This stuff appears to be made in France by the "real" Servier, hehheh.
Seems to be stronger...I feel a bit "hypomanic" and irritable.
Can Stablon become more potent with age? Does anyone know?
Of course, I also just recently moved (on 8 May) so I've felt quite stressed out...maybe it's just the stress.
Posted by sukarno on May 25, 2005, at 7:00:46
In reply to Re: Nardil,Imipramine » sukarno, posted by Chairman_MAO on May 7, 2005, at 12:11:17
Chairman MAO said:
> I have to say, now that the adjustment "brain shocks" have subsided (after only about 5 days)I've been wanting to ask you about that but kept putting it off. Sorry.
Can you describe those "brain shocks"? Is it anything like the "zaps" you get during SSRI withdrawal?I wonder if zaps are a result of SSRI neurotoxicity or because of serotonin fluctuations.
Posted by sukarno on June 24, 2005, at 5:16:10
In reply to Developing side effects to tianeptine (Stablon), posted by sukarno on March 25, 2005, at 5:30:58
I'm curious if anyone else here has taken Stablon (tianeptine, an atypical tricyclic antidepressant...supposedly with no anticholinergic action).
Have you ever felt thirsty on it? I never have until recently. I had raised the dose from 25mg to 37.5mg (2 to 3 tablets respectively) and noticed some thirst, sometimes intense. I now drink double (3 litres) the amount of water than I used to.
Is this something I should be concerned about? I thought Stablon doesn't have anticholinergic or antihistaminic effects.
Ed, are you still around? You know a lot about psychopharmacology. :)
I also have been steadily raising my Pepcid (famotidine) dose to quite a high level. I'm on 20mg 6 to 8 times a day since I'm developing a tolerance to it and the acid was coming back (I have GERD).
I'm not sure which drug is responsible...or maybe both are.
Can Pepcid, since it is an H2 receptor antagonist become *nonselective* and target H1 histamine receptors too?
Thanks in advance! I drink a lot of water but it doesn't seem to help, but if I lower the Pepcid, the acid will come back with a vengeance and if I cut the Stablon down I'll get some headaches as a withdrawal reaction.
Thanks again. :)
Paul
Posted by ed_uk on June 24, 2005, at 10:26:25
In reply to Dry mouth.... Stablon (tianeptine) side-effect?, posted by sukarno on June 24, 2005, at 5:16:10
Hi Paul!
Apparantly, 20% of patients treated with tianeptine get a dry mouth. I expect the true figure is higher though because this study seems to underestimate side effects! Only 17% got drowsy on amitriptyline - I think not LOL!
The incidence of dry mouth (38 vs 20%), constipation (19 vs 15%), dizziness/syncope (23 vs 13%), drowsiness (17 vs 10%) and postural hypotension (8 vs 3%) are greater with amitriptyline than with tianeptine. Insomnia and nightmares occur in more tianeptine than amitriptyline recipients (20 vs 7%).
>thirst, sometimes intense.......
>Is this something I should be concerned about?Probably not ...but I think it would be worth seeing your doctor and getting a few tests done eg. blood glucose for diabetes etc.
>I also have been steadily raising my Pepcid (famotidine) dose to quite a high level.
Dry mouth is listed as a side effect of Pepcid but I don't think it's common.
> I'm on 20mg 6 to 8 times a day since I'm developing a tolerance to it and the acid was coming back (I have GERD).
I hope the high dose is helping :-) Perhaps you should see a gastro-enterologist. Have you tried a proton pump inhibitor eg. lansoprazole? They can be more effective than H2 antagonists for some people.
Kind regards
~Ed
Posted by sukarno on July 9, 2005, at 11:31:28
In reply to Developing side effects to tianeptine (Stablon), posted by sukarno on March 25, 2005, at 5:30:58
Hi everyone! :-)
I was taking 12,5mg Stablon 3 times a day and about two weeks ago it began to "poop out". It was horrible. I admit I was under a lot of extra stress, but even after a good night's sleep I would wake up feeling hopeless with the depression returning full force. My life quickly became doom & gloom..plus some anxiety.
So, I raised the dose to 12,5mg 4 times a day and within one or two days my mood was right back to normal and I was once again feeling great.... positive thinking and outlook on life, looking forward to the future... began to renovate my house, etc.
I feel good now, but my concern is that Stablon might "poop out" again in the future.
I've heard of SSRIs doing that, but this isn't an SSRI.
It does have a very short half-life though... (only 3 hours). Would that have anything to do with the tolerance ("poop out")?Thanks in advance! :-)
Paul
Posted by ed_uk on July 9, 2005, at 11:42:54
In reply to Tianeptine tolerance, depression returns, posted by sukarno on July 9, 2005, at 11:31:28
Hi Paul!
>I would wake up feeling hopeless with the depression returning full force.
I'm sorry to hear that :-(
>It does have a very short half-life though... (only 3 hours). Would that have anything to do with the tolerance ("poop out")?
I don't think its short half-life is the cause of poop out ........but drugs with short half lives do seem to be associated with withdrawal symptoms between doses. Taking a small dose every few hours might be helpful.
Kind regards
~Ed
Posted by sukarno on July 17, 2005, at 23:33:39
In reply to Developing side effects to tianeptine (Stablon), posted by sukarno on March 25, 2005, at 5:30:58
I called Servier in Indonesia today and asked them what the maximum dosage is and the representative said, "We only recommend 1 tablet 3 times a day, sir."
I kept trying to ask him if there is a maximum dosage since 1 tablet 3 times a day doesn't work for me, so I take 1 tablet 4 times a day.
He acted like a robot and repeated the same thing he said before.
Does anyone here have any information about the various dosages? I do recall reading in clinical trials that Stablon was used up to 75mg/day in divided doses, so that would be 6 tablets a day.
Ed, do you know about this? All other drugs have a range of dosages, but Servier is a bit strange...seems like with any drug they produce they slap on a "one size fits all" type dosing regimen.
Thanks in advance! :-)
p.s. I did find Survector but it is expired and the Servier representative said they quit producing it at least 5 years ago. He didn't give any particular reason why they ceased production. I asked him if it was because of low demand and he said there was high demand but they just don't make it anymore. Hmm... no explanation at all why they quit (although we all know why hehheh).
I hope this isn't counterfeit Survector. It comes in strips of six 100mg tablets, still in the blister package but not in the cardboard box. Here in Indonesia, counterfeit drugs have been produced that looked so genuine almost no one noticed....even down to the blister package. Very clever counterfeiting has been accomplished here... quite scary. :-(
It is expired though, but cheaper than Stablon when I add up the cost of taking 4 Stablon per day vs. 1/2 or 1 Survector per day.
Posted by ed_uk on July 18, 2005, at 13:29:15
In reply to Maximum dosage for Stablon (tianeptine), posted by sukarno on July 17, 2005, at 23:33:39
Hi!
Some people take A LOT!
'We report on a tianeptine dependence lasting for eighteen months in a 42 year old patient............Tianeptine was prescribed for a major depressive disorder. The patient alleged a "flash sensation" like with heroin since the very first doses with a physical and psychological well-being sensation, better psychomotor performances and transient mood elation. His addiction to tianeptine was immediate and heavy. The positive reinforcement faded away after one month and a total dependance took over, with physical and psychological withdrawal symptoms when doses were not renewed. After two months of treatment, the daily consumption of tianeptine was of 90 tablets. The patient was hospitalised to treat both the addiction to tianeptine and the ongoing major depressive disorder. He was taking 240 tablets daily.'
'The authors report a case of tianeptine abuse in a 30 year-old woman. After a medical prescription of the recommended dosage of 12.5 mg 3 times daily of oral tianeptine for a depressive illness, the patient spontaneously increased the dosage which after two months reached 150 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect. After seven months of such a therapy, she was hospitalized to undergo a withdrawal. The discontinuation of the tianeptine treatment occurs in four days. A withdrawal syndrome marked by myalgia, and cold feeling was transient, and alleviated by sedative phenothiazine (cyamemazine) and myorelaxant benzodiazepine (tetrazepam).'
>I kept trying to ask him if there is a maximum dosage.......
Manufacturers will only ever recommend the approved dose. They are protecting themselves from litigation in case anything goes wrong.
>I do recall reading in clinical trials that Stablon was used up to 75mg/day in divided doses, so that would be 6 tablets a day.
Get your liver function tests measured! Liver toxicity seems to be a concern.
Kind regards
~Ed
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