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Comment · Fri, January 24, 2014

Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants

What they were answering

probablytoomuch · 1 points

I would say the same- I've been on TCA's, SSRI's, SNRI's, NaSSAs, atypical antipsychotics, and lithium, so serotonin changes are kind of my bag. Plus, I've been on it for a couple months now, so the initial response period should have changed. However, it does make me realize that I'm on lithium+tianeptine. Lithium's kind of got a generally mysterious MOA, as does tianeptine, so maybe there's something there.

It doesn't really bother me, and I continue to purchase your tianepetine regularly, as it works quite well. It's the oddly specific irritability it seems to create. I'll be in an excellent mood, something will irritate me and I'll say something like I'm silently fuming the whole time, but then I'll go right back to feeling great. It gives the impression I'm doing worse than usual when in reality I'm doing much better. I'm curious if your girlfriend feels the same.

The problem could be a hypersensitivity to emotional stimulus itself, such that an automatic, annoyed outburst occurs before it can be really processed. If I'm not mistaken, its current theorized mechanism of action is mostly glutaminergic. I wonder if people who tend to already have heightened amygdala activation (as my disorder set indicates- not sure about your girlfriend) respond to the glutaminergic action with automatic irritable outbursts to stress.

I dunno, it could be nonsense.

u/MisterYouAreSoDumb

No, I think you are on to something. I get the same irritability sometimes when on racetams. Perhaps it has more to do with glutamate than serotonin. Since racetams are positive allosteric modulators of glutamate, and tianeptine modulates glutamate receptors too, that might be the crux of the irritability.

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