Tianeptin und Pregabalin bei Borderline und Depression?

Borderline is a personality disorder. A personality disorder can only be treated psychotherapeutically and not medicamentally. In other words, there are no drugs against personality disorders, only against their subsequent symptoms such as depression, anxiety disorders or impulse control disorders.

Depression is a frequent follow-up symptoms of Borderline, but in the majority also occur regardless of personality disorders. There are numerous drugs that can be used to treat depression. Above all antidepressants which, unfortunately, are not sufficiently effective for all concerned. Often, so-called additional drugs such as mood stabilizers (e.g. lithium or lamotrigine) as well as atypical antipsychotics (e.g. queitapine or aripiprazole) are also used.

Tianeptin is a drug from the group of atypical antidepressants. It has a completely different mechanism of action than all other antidepressants. In concrete terms, Tianeptin in particular at the beginning of the treatment strengthens the resumption of the neurotransmitter serotonin while almost all other antidepressants inhibit resumption. Tianeptin also acts as a partial agonist on certain opioid receptors and has a modulating effect on the NMDA and AMPA receptors (glutamic acid). Tianeptin is admitted exclusively for the treatment of depression. In addition, it also has an anxious effect for certain consumers.

The advantage of tianeptin is primarily that under this drug there is usually neither a weight increase nor sexual dysfunction. The disadvantage is the often somewhat poorer effectiveness in severe depression and the weaker pronounced anxiety-reducing effect (as in other antidepressants such as the SSRIs). Tianeptin, like all antidepressants, must be taken daily, often distributed over 2-3 administrations per day. An antidepressive action develops after approx. 2-5 weeks… if you’re talking to the drug.

Pregabalin is an anti-epileptic with anxious action. It is approved for the treatment of anxiety disorders, epilepsy and neuropathic pain. Pregabalin must also be taken daily, usually also distributed over 2-3 administrations. The effect should occur after 1-3 weeks if you respond to the drug.

Pregabalin has a completely different mechanism of action than all other anxious drugs. It strongly simplifies the release of the neurotransmitter glutamic acid, norepinephrine and the substance P. However, the side effect profile is not better than that of numerous antidepressants. There are also rare case reports about dependence and addiction developments at Pregabalin. People with addiction diseases are primarily concerned (but not exclusively) in their history.