Posted by Brainbeard on February 26, 2010, at 6:52:34
In reply to Re: Tianeptine for escitalopram's emotional blunting?, posted by vic80 on February 26, 2010, at 2:16:53
Tianeptine taken long term has a net result on serotonin transmission similar to the SSRI's. There are differences, of course; tianeptine is also mildly pro-dopaminergic, and it lacks the sexual side-effects typical of the SSRI's. But the statement that tianeptine enhances emotions while SSRI's numb them has turned out to be more of a myth than a factual truth. Long term use of tianeptine can foster a same kind of emotional indifference as the SSRI's, in my experience and those of others. The numbness may be milder though.
Adding tianeptine to an SSRI may not be an effective strategy. Tianeptine is such a mild med that I suspect any SSRI would blow it right away in terms of having any therapeutic effect.
Taken in higher doses, tianeptine has a more pronounced prodopaminergic effect, which may lead to euphoria and stimulation. People who use it recreationally speak of taking at least 10 12.5mg tablets for creating this effect. If I take two or more tablets PRN, the drug has an immediate mood-lifting and mildly stimulating effect on me. Tianeptine also stimulates my libido, at least the mental part of it, but oddly perhaps, SSRI's do the same.
I agree with what has been said before about adding a noradrenergic drug or a drug that hits different neurotransmitters.
If you want to switch over to tianeptine, my advice would be to quit the escitalopram completely.
poster:Brainbeard
thread:937868
URL: http://www.dr-bob.org/babble/20100216/msgs/937929.html