Question:
Tianeptine is a 5-HT re-uptake enhancer. Period. As you would have discovered
had you done even the most cursory checks before rushing into print to
display your ignorance.
It does the exact opposite to what SSRIs do. Yet it is by all accounts a very
effective antidepressant, and possibly even safer than the SSRIs (one patient
was taking 150 tablets/day (std dose=3) for some months without apparent ill
effect, not something I'd try with Prozac or Paxil!!).
Answer:
I don't have a problem with SSRIs, or any other antidepressant for that
matter.
What I do object to though is this bullshit that benzodoazepines are the work
of the devil and the only true path to anxiety salvation is via SSRIs.
Fact: Only about 70% of depression patients are helped by antidepressants
generally, the figure for SSRIs, specifically, would be lower. The remaining
30% either derive no benefit from ADs, or find the side effects so
intolerable that they stop taking them.
Fact: Anxiety and panic patients are even more effected by some of the side
effects, especially the initial increased anxiety they cause until the
increased synaptic serotonin effect ends as neuro adaption occurs. My guess
is that only about 60% are successfully treated with ADs. Thats 40% left
wandering in the anxiety wilderness.
Fact A lot more could be successfully started on ADs if their doctors
prescribed benzos to help them over the serotonin hump. But most don't for
the same ignorant reasons you've given for your oposition to these meds.
Fact: Psychotherapies also only help about 70% of those that are treated, at
least in the short term. But the few long term studies that have ben
conducted show they are not much better than having done nothing. Not a
failing of the therapies, but of human nature.
Fact: There is a great overlap in those that respond to ADs and those that
respond to psychotherapy, so the non responder group is much the same too.
So what do all those patients who can't use ADs, and have relapsed from CBT
etc, do. You and the other anti benzo zealots seek to deny them a class of
drug that is about 95% effective, and scare them shitless in the process.
I know what some doctors do. There anti benzo parinoya is so strong that they
subject their non responders to an ever increasing mix of drugs. Initially
just the ADs-almost always a SSRI, then a mood stabilizer is added, usually
followed by an antipsychotic and ending with Ritilin or one of it relatives
on the side. Their patients end up rattling their way through life, bombed
out on a drug cocktail that will cause them much more harm than any
benzodiazepine ever would.
Given the choice between a benzo and an antipsychotic, I know which I'd
choose!
And all because of this crazy idea that benzos are addictive, even when the
evidence shows they rarely are when taken in therapeutic doses by those with
anxiety disorders.
The only reason why you consider ssri's as safer than benzos is because they
are not addictive in YOUR opinion. While benzos do not work in all people
(and I am one of them) for some people they provide very good anxiety relief
without almost any side-effects. Also there is a group of people (and you propably
know this) in which most antidepressants just makes them more apaethic, more anxious
and even more depressed.
