Wednesday, August 30, 2017

What's the Deal With: Tianeptine?

If you're hip to the nootropic community, you may have heard about tianeptine--an antidepressant "mood brightener" that is unlike anything prescribed in the U.S.  It is said to hold enormous promise & be something of a miracle drug for some people with treatment resistant depression.  But it can also have a bit of a dark side.  Read on for more on that. 

Sold under the brand names Stablon and Coaxil, tianeptine sodium is a fast-acting antidepressant and anxiolytic that is prescribed all over Europe & Asia.  It was once thought to work by enhancing the reuptake of serotonin--the polar opposite of what SSRI's like Zoloft & Prozac do.  In 2014, it was found to work by directly affecting mu-opioid receptors; in other words, the same receptors affected by drugs like morphine & hydrocodone.  Like other antidepressants, tianeptine spurs neurogenesis (the growth of new brain cells), which is thought to be impaired in people with depression.

I discovered tianeptine during the lowest point in my life--benzo withdrawal.  I'd abused etizolam daily for about 10 months before quitting cold turkey, which sent me into a 2 1/2 year spiral of withdrawal Hell.  Not Post-Acute Withdrawal Syndrome (PAWS) like you get from opiates, but acute, severe withdrawals.  FOR TWO AND A HALF YEARS.  Every substance I tried to take during that first year had the opposite effect--Valerian root, hydrocodone, lemon balm and anything else "relaxing" or sedating acted like a stimulant, sending my heart into overdrive & causing a cold, sweaty panic attack. 

While researching possible remedies, I found a study claiming that tianeptine was useful during benzo withdrawal & decided to try it.  People in the nootropic community were all abuzz with positive stories about tianeptine at that time.  I started with tianeptine sodium--the same kind that's in prescription forms of the drug in other countries.  It was highly effective but incredibly short-lived, requiring frequent re-dosing to avoid a "crash" in my mood. 

While on tianeptine, I became incredibly immersed in whatever I was doing.  Boring shit instantly became the most interesting thing in the world.  And then it would wear off.  The side effects were mild and included stomach irritation, constipation & dry mouth.  I liken the effects to an opiate that only affects your mind, not your body.  No warm body buzz, no muscle relaxation...just a "brightened" mood & sense of calm. 

Then I learned about a different form of the drug--tianeptine sulfate.  The sulfate form was supposedly longer-acting and thus had a milder crash & didn't require frequent dosing.  The problem?  It hadn't been produced by pharmaceutical companies or studied in humans yet.  I was willing to be a guinea pig after my initial success with the sodium form.  The grey-market research chemical community was able to produce tianeptine sulfate in bulk, sourcing most of it from Chinese labs. 

Tianeptine sulfate lived up to the hype--it was less fiendish & had a smoother onset and come-down.  It was on the more relaxing end of the spectrum than the sodium form, which felt more stimulating.  I'd start my day with a 35mg dose of tianeptine sulfate & take my tianeptine sodium before going to the gym in the evening, then end my day with another dose of the sulfate.  It was a great addition to my antidepressant regimen.  And it can be safely taken with SSRI's, SNRI's and other popular psych meds in people without liver problems. 

The dark side?  I stumbled upon a Reddit community where nearly every tianeptine user was an addict, taking upwards of a gram per day.  THE RECOMMENDED DOSE IS 12.5 MG 3 TIMES PER DAY.  Let that soak in for a minute.  These people were treating tianeptine like heroin or oxy, which was a shock to me as I never found it very recreational. 

Then I found reports of desperate Russian addicts losing arms & other limbs by injecting Coaxil (the Russian name for tianeptine sodium).  This was happening parallel to the krokodil epidemic, causing many young Russians to lose their limbs and even their lives.  Tianeptine turns into a gluey substance as soon as it hits the air, which is likely responsible for clogging up veins & causing gangrene.  In any case, this was far more serious than anything I'd heard about tianeptine to date and definitely cause for caution.

The verdict?  Tianeptine can be a great addition to your anxiety/depression treatment tool kit if used properly.  It works instantly, unlike other antidepressants that can take up to a month to start working.  But if you've ever been addicted to drugs or alcohol, avoid it like the plague or use with extreme caution.  If you're looking for an opiate high there are far better & safer drugs to use.  Make sure to invest in a milligram scale before trying tianeptine, as getting the dose right is vital to safe use.  Oh, and be careful to choose a reputable vendor to avoid adulterants or other quality issues.  While tianeptine sodium is available in pill form from overseas pharmacies, it's expensive.  Very expensive.  So most people use the grey-market powder.  There's always a risk when buying strange white powders on the internet. 

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