TIANEPTINE

OTHER NAME(S):

Tiannaa, Stablon, Coaxil.

Overview

Overview Information

Tianeptine is a prescription drug for depression in some European, Asian, and Latin American countries. Tianeptine is not approved as a prescription drug or dietary supplement in the U.S.

Tianeptine is most commonly used for depression. It is also used for pain, asthma, anxiety, and other conditions, but there is no good scientific evidence to support these uses. Tianeptine might also be unsafe. Tianeptine has been associated with dependence, withdrawal, and serious adverse events including death.

How does it work?

Tianeptine is chemical that affects brain chemicals. It seems to affect mood when used in low doses. In higher doses, it works like an opioid and can cause addiction and other serious side effects. It can also cause withdrawal.
Uses

Uses & Effectiveness?

Possibly Effective for

  • Depression. Prescription tianeptine (not available in the U.S.) seems to reduce depressive symptoms in people with depression. It might work as well as certain other medicines commonly used for depression.

Insufficient Evidence for

Side Effects

Side Effects & Safety

When taken by mouth: Tianeptine is POSSIBLY UNSAFE when taken by mouth. While tianeptine is available by prescription in certain countries, it has a risk of misuse and abuse. Taking high doses of tianeptine can cause drowsiness, confusion, difficulty breathing, coma, and death. Use of tianeptine over a long time can cause withdrawal.

When given by IV: Tianeptine is LIKELY UNSAFE when given by IV. Tianeptine can cause drowsiness, confusion, difficulty breathing, coma, and death. Use of tianeptine over a long time can cause withdrawal. Tianeptine is not approve for IV use in the U.S. or elsewhere.

Special Precautions & Warnings:

Pregnancy: Tianeptine is POSSIBLY UNSAFE when taken by mouth during pregnancy. It can cause the infants to be born addicted to tianeptine. Infants present with symptoms of crying, sweating, poor feeding, and vomiting.

Breast-feeding: There is not enough reliable information about the safety of taking tianeptine if you are breast-feeding. But other drugs that are similar to tianeptine are known to enter the breastmilk when used by the mother. Stay on the safe side and avoid use.

History of drug abuse: Using tianeptine for a long time can cause dependence and withdrawal, especially in people that have been addicted to other chemicals. Do not take tianeptine if you have had an addiction.

Surgery: Tianeptine may have sedative effects in higher doses. Healthcare providers worry that anesthesia and other medications during and after surgery might increase this effect. Stop taking tianeptine at least 2 weeks before a scheduled surgery.

Interactions

Interactions?

We currently have no information for TIANEPTINE Interactions.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULTS
BY MOUTH:

  • Depression: 25 or 37.5 mg of tianeptine daily has been used as a prescription drug under the guidance of a healthcare professional. Tianeptine is not available as a prescription drug in the U.S.

View References

REFERENCES:

  • Awad, R., Arnason, J. T., Trudeau, V., Bergeron, C., Budzinski, J. W., Foster, B. C., and Merali, Z. Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties. Phytomedicine. 2003;10(8):640-649. View abstract.
  • Bakota EL, Samms WC, Gray TR, Oleske DA, Hines MO. Case Reports of Fatalities Involving Tianeptine in the United States. J Anal Toxicol. 2018;42(7):503-509. View abstract.
  • Bence C, Bonord A, Rebillard C, et al. Neonatal Abstinence Syndrome Following Tianeptine Dependence During Pregnancy. Pediatrics. 2016;137(1). View abstract.
  • Dempsey SK, Poklis JL, Sweat K, Cumpston K, Wolf CE. Acute Toxicity From Intravenous Use of the Tricyclic Antidepressant Tianeptine. J Anal Toxicol. 2017;41(6):547-550. View abstract.
  • El Zahran T, Schier J, Glidden E, et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System - United States, 2000-2017. MMWR Morb Mortal Wkly Rep. 2018;67(30):815-818. View abstract.
  • Goodnough R, Li K, Fouladkou F, et al. Notes from the Field: Toxic Leukoencephalopathy Associated with Tianeptine Misuse - California, 2017. MMWR Morb Mortal Wkly Rep. 2018;67(27):769-770. View abstract.
  • Grasela TH, Fiedler-Kelly JB, Salvadori C, Marey C, Jochemsen R. Development of a population pharmacokinetic database for tianeptine. Eur J Clin Pharmacol. 1993;45(2):173-9. View abstract.
  • Guelfi JD, Dulcire C, Le Moine P, Tafani A. Clinical safety and efficacy of tianeptine in 1,858 depressed patients treated in general practice. Neuropsychobiology. 1992;25(3):140-8. View abstract.
  • Gupta S, Wallace R, Sloshower J. Online Sales of Unscheduled Pharmaceutical Agents: A Case Report of Tianeptine Use in the United States. J Addict Med. 2017;11(5):411-412. View abstract.
  • Jeon HJ, Woo JM, Lee SH, et al. Improvement in subjective and objective neurocognitive functions in patients with major depressive disorder: a 12-week, multicenter, randomized trial of tianeptine versus escitalopram, the CAMPION study. J Clin Psychopharmacol. 2014;34(2):218-25. View abstract.
  • Kasper S, Olié JP. A meta-analysis of randomized controlled trials of tianeptine versus SSRI in the short-term treatment of depression. Eur Psychiatry. 2002;17 Suppl 3:331-40. View abstract.
  • Lauhan R, Hsu A, Alam A, Beizai K. Tianeptine Abuse and Dependence: Case Report and Literature Review. Psychosomatics. 2018;59(6):547-553. View abstract.
  • Le Bricquir Y, Larrey D, Blanc P, Pageaux GP, Michel H. Tianeptine--an instance of drug-induced hepatotoxicity predicted by prospective experimental studies. J Hepatol. 1994;21(5):771-3. View abstract.
  • Lechin F, van der Dijs B, Hernández G, Orozco B, Rodríguez S, Baez S. Acute effects of tianeptine on circulating neurotransmitters and cardiovascular parameters. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(2):214-22. View abstract.
  • Lechin F, van der Dijs B, Lechin AE. Treatment of bronchial asthma with tianeptine. Methods Find Exp Clin Pharmacol. 2004;26(9):697-701. View abstract.
  • Lechin F, van der Dijs B, Orozco B, et al. The serotonin uptake-enhancing drug tianeptine suppresses asthmatic symptoms in children: a double-blind, crossover, placebo-controlled study. J Clin Pharmacol. 1998;38(10):918-25. View abstract.
  • Lucaj S, Leo RJ. Tianeptine Sodium: A Nootropic With Potentially Lethal Consequences. Prim Care Companion CNS Disord. 2018;20(4). View abstract.
  • Marraffa JM, Stork CM, Hoffman RS, Su MK. Poison control center experience with tianeptine: an unregulated pharmaceutical product with potential for abuse. Clin Toxicol (Phila). 2018;56(11):1155-1158. View abstract.
  • Rouby F, Pradel V, Frauger E, et al. Assessment of abuse of tianeptine from a reimbursement database using 'doctor-shopping' as an indicator. Fundam Clin Pharmacol. 2012;26(2):286-94. View abstract.
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  • Salvadori C, Ward C, Defrance R, Hopkins R. The pharmacokinetics of the antidepressant tianeptine and its main metabolite in healthy humans--influence of alcohol co-administration. Fundam Clin Pharmacol. 1990;4(1):115-25. View abstract.
  • Samuels BA, Nautiyal KM, Kruegel AC, et al. The Behavioral Effects of the Antidepressant Tianeptine Require the Mu-Opioid Receptor. Neuropsychopharmacology. 2017;42(10):2052-2063. View abstract.
  • Sohn W, Lee OY, Kwon JG, et al. Tianeptine vs amitriptyline for the treatment of irritable bowel syndrome with diarrhea: a multicenter, open-label, non-inferiority, randomized controlled study. Neurogastroenterol Motil. 2012;24(9):860-e398. View abstract.
  • Summary of Product Characteristics Stablo: Tianeptine. 2008. Available at: https://www.servier.com.ve/sites/default/files/spc-pil/spc-stablon.pdf
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  • Voican CS, Corruble E, Naveau S, Perlemuter G. Antidepressant-induced liver injury: a review for clinicians. Am J Psychiatry. 2014;171(4):404-15. View abstract.
  • Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med 2003;9:74-8. View abstract.
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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2018.