DEAR DR. ROACH: I’ve been hearing about tianeptine being sold at gas stations. Is it really dangerous?
ANSWER: Like so many substances, tianeptine can be a useful drug when prescribed and taken correctly , but is indeed dangerous when used recreationally. Its use has been banned in several states across the U.S. It is sold as a dietary supplement. Because it acts on the same receptor as morphine , when used at high doses, far beyond the medically approved dose, it has potential for abuse and even overdose, with a handful of deaths ascribed to its use.
DEAR DR. ROACH: I have severe pain in my right shoulder. I have seen two orthopedists and received X-rays, MRI scans, and a cortisone injection, which didn’t work. Both surgeons recommended a shoulder replacement. I am taking three adult aspirins each morning , and the pain is gone. Is this safe? I am 83 and otherwise healthy.
However, people have long taken aspirin, sometimes at much higher doses, usually without problems. The fact that you are taking it only once a day reduces the toxicity, but I have to say I am surprised the benefit is lasting all day. There are many classes of NSAIDs, with very different chemical properties, and it is likely there is another type of NSAID you could safely take, with lower risk than the dose of aspirin you are currently on. On the other hand, you can’t get any better effectiveness, at least in terms of pain, and the absolute risk is still fairly small, so I’m not sure I would recommend you change.
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