Tianeptine: uses and side effects of this drug

This drug is often used in treatments for depression.

Major depression is one of the most common mental disorders in the population, and the search for therapeutic alternatives for its treatment is of great importance. The use of psychotropic drugs is one of these alternatives, being many substances classified as antidepressants and having among them mechanisms of action that may differ to a greater or lesser extent.

Some of these substances may even have an effect through a mechanism of action that may seem contrary to that of most of these types of drugs. This is what happens with tianeptineabout which we are going to talk in this article.

What is tianeptine

Tianeptine is a psychopharmaceutical synthesized in the 1970s, which was created to combat depressive symptomatology. This Antidepressant has interesting propertiesIt has been shown to have a level of efficacy similar to that of substances such as fluoxetine, and it is also fast acting, with the first effects occurring around one or two weeks after the first use (generally, antidepressants take around one month). It has also been used as an adjuvant treatment to improve the effectiveness of other antidepressants, as well as other disorders such as anxiety and stress.

It has sometimes been classified as a tricyclic because it has the same chemical structure, but the truth is that its mechanism of action does not correspond to that of this group. In fact, it could rather be classified differentially in a new category: by its mechanism of action, as opposed to that of the specific serotonin reuptake inhibitors or SSRIs, tianeptine is the main representative of the serotonin reuptake enhancers or SSRIs..

Despite its efficacy and usefulness, tianeptine is not particularly well known or used because of its relatively high risk of dependence (it is even classified as a narcotic drug in countries such as France) and is not authorized as an antidepressant in many countries because the risk-benefit balance is considered to be at best slightly favorable. However, if it is sold in other ways, because it has nootropic and it has nootropic effects and improves memory.. In our country it has begun to be marketed as an antidepressant in 2015, but other alternatives are usually used as first-line treatment.

Mechanism of action.

Tianeptine is a unique antidepressant due to its peculiar mechanism of action. Unlike other popular antidepressants such as SSRIs, which inhibit the reuptake of serotonin in such a way as to increase the amount of this hormone in the brain, tianeptine works by greatly enhancing the reuptake of serotonin.

Although it may seem that this mechanism of action is counterproductive, the truth is that tianeptine is effective in the treatment of depressive symptomatology. Although the amount of serotonin present in the synaptic space is reuptaken, it seems that it also acts by enhancing the reuptake of serotonin. by enhancing communication between neurons in the serotonergic pathways.. The drug itself does not appear to bind to any receptors.

It also reduces corticotropin and glucocorticoid levels, which makes it useful in the fight against stress. It also reduces the activity of the hypothalamic-pituitary-adrenocortical axis. It also contributes to increase the levels of acetylcholine in the brain (among other reasons because it reduces the level of serotonin). Finally, it also seems to modify the functioning and transmission of glutamate, normalizing in stressful situations.normalizing in stressful situations.

Applications and indications.

Tianeptine is a psychopharmaceutical that has been used in different disorders and with different applications. The first and most notable is its indication in major depression and other depressive disorders, in which, as mentioned, it has an efficacy comparable to that of such popular drugs as SSRIs.

It is also very useful in the treatment of disorders related to anxiety and even somatic disorders, without having any negative effect on the level of consciousness. It has been shown to be very useful for the treatment of stress, preserving also from damages derived from its continuous experience in areas such as the hypothalamus.

Finally, tianeptine is also marketed as a dietary supplement in some countries because of its because of its ability to facilitate increased levels of acetylcholine, which promotes attention and learning and facilitates memorization and recall.

Side effects and contraindications

Tianeptine is a drug with a considerable level of efficacy. Unlike other drugs, it does not cause sexual alterations, nor does it increase weight. It has not been found to cause arrhythmias or heart problems, and it is especially well known that it does not cause drowsiness. However, its consumption can generate different side effects.

Among the side effects that we can find, tianeptine could generate dizziness and lightheadedness, tremor, abdominal pain, headache and cold symptoms.. Also asthmatic crises, anorexia or loss of appetite, pain, palpitations, tachycardia, flushing and asthenia. In subjects with a history of psychotic outbreaks, it may facilitate their reappearance. Likewise, one of the great risks of this drug is that it has a great potential to generate dependence, and the subject who consumes it can become addicted. This is one of the main factors why its use has not become popular and in fact it is not marketed in different countries.

As main contraindications it is worth mentioning that this type of drug should not be consumed by subjects who are taking antidepressants of the MAOI type, or before the application of an anesthetic.or before the application of an anesthetic. It is also contraindicated in subjects with addiction problems (although it is used in depressions with alcoholism), subjects with positive psychotic symptomatology and/or manic episodes. Pregnant women, nursing mothers or minors, as well as people with renal problems should take great caution.

Bibliographic references:

• McEwen, B.S.; Chattarji, S.; Diamond, D.M.; Jay, T.M.; Reagan, L.P.; Svenningsson, P. & Fuchs, E. (2010). The neurobiological properties of Tianeptine (Stablon): from monoamine hypothesis to glutamatergic modulation. Mol Psychiatry.; 15(3): 237-49. doi:10.1038/mp.2009.80.
• Watanabe, Y.; Gould, E.; Daniels, D.C.; Cameron, H. & McEwen, B.S. (1992). Tianeptine attenuates stress-induced morphological changes in the hippocampus. European Journal of Pharmacology; 222: 157-16.
• Calabozo, B.; Molina, V. & Uribe, F. (2016). Tianeptine: why in Spain it has not been classified as a narcotic drug. Rev Psychiatr Health ;ent; 9 (3): 176-177.