Tianeptine (Stablon, Coaxil, Tatnol)
Tianeptine is an atypical antidepressant that is used in Europe and other parts of the world. It is manufactured by Servier Pharmaceutics in France, and is not available in the US. Pharmos has the drug in its development pipeline as a treatment for IBS, but is not actively developing it at this time.
The Bottom Line: What You Really Need to Know
- Tianeptine is used to treat depression, anxiety, chronic pain, asthma, erectile dysfunction, ADD, fibromyalgia and other problems.
- The usual dose is 12.5 mg three times a day. Tianeptine does not need to be increased or withdrawn slowly.
- Tianeptine interacts with other medications. Make sure your doctor and pharmacist know about all of the medications you take, including over-the-counter medications, herbal remedies, homeopathic remedies, vitamins, supplements and medications you only take occasionally.
- It will probably be a week or two before you notice any difference in the way you feel.
- Most people have a few mild side effects, like dry mouth or constipation, when they start taking tianeptine. They usually go away with time.
- Have a friend or family member check in with you every day for the first few weeks you take tianeptine. Ask him or her to help monitor your condition for
- Worsening depression
- Restlessness, irritability, agitation, hostility or aggression
- Unusual thoughts or thoughts of suicide
- Report any serious or unusual side effects to your doctor.
- Women who are trying to get pregnant or are pregnant or nursing should not take tianeptine.
- Children under the age of 15 should not take tianeptine.
Uses
Tianeptine is indicated for the treatment of depression. It is also used to treat anxiety and panic attacks. The medication has other uses, including the treatment of asthma, depression with erectile dysfunction, ADD and ADHD and fibromyalgia. It is being considered as a treatment for IBS in the US.
Tianeptine decreases anxiety and brightens mood without either oversedation or overstimulation.
Dosage
The usual dose of tianeptine is 12.5 mg three times a day before meals. There is no need to gradually increase the dose or to taper it before discontinuation.
How tianeptine works
Tianeptine is a modified tricyclic antidepressant. In contrast to other antidepressants, tianeptine enhances serotonin reuptake (it's an SSRE medication), and it works mostly in the cerebral cortex and hippocampus of the brain.
The development of tianeptine is the result of exciting new brain research that focuses on the architecture of the brain in addition to neurotransmission. Tianeptine enhances "neuroplasticity," which has to do with brain architecture. Specifically, the actions of tianeptine are:
- It enhances serotonin reuptake in the cortex and hippocampus
- It normalizes gene expression of certain neurochemicals
- It causes the dendritic extensions of nerve cells to grow and branch
- It regulates the concentrations of various chemicals in the brain
- It increases the volume (size) of the hippocampus
- It regulates the rate of programmed cell death in the hippocampus and temporal cortex
Side Effects
Side effects are rare and are usually mild to moderate in severity. They can include:
- Dry mouth
- Constipation
- Dizziness or fainting, especially when you suddenly stand up
- Drowsiness
- Insomnia
- Nightmares
- Headache
- Rare reports of liver toxicity have occurred.
Interactions
Tianeptine may interact with monamine oxidase inhibiting antidepressants (MAOIs).
Precautions
Tianeptine should not be taken with MAOIs.
It should not be taken by children under the age of 15.
It should not be taken by women who are or wish to become pregnant or during lactation.
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