Tianeptine: uses and side effects of this drug
Major depression is one of the most common mental disorders in the population, and the search for therapeutic alternatives for treatment is of great relevance. The use of psychotropic drugs is one such alternative, with many substances classified as antidepressants and having mechanisms of action among them that may differ to a greater or lesser extent.
Some of these substances can even have an effect through a mechanism of action that may seem contrary to most of this type of drugs. This is what happens with tianeptine , about which we are going to talk about in this article.
- Related article: "Types of psychotropic drugs: uses and side effects"
What is tianeptine
Tianeptine is a psychoactive drug synthesized in the seventies, which was created in order to combat depressive symptomatology. This antidepressant has interesting properties , and has been shown to have a level of efficacy similar to that of substances such as fluoxetine, also presenting a rapid action to have the first effects about one or two weeks after the first use (usually, antidepressants take around one month). It has also been used as a coadjuvant treatment to improve the effectiveness of other antidepressants, as well as other disorders such as anxiety and stress.
Sometimes it has been classified as 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 specific inhibitors of serotonin reuptake or SSRIs, thianeptine is the main representative of the enhancers of serotonin reuptake or PSRS .
Despite its efficacy and usefulness, thianeptine is not usually known or used because it has a relatively high risk of dependence (it is classified as a narcotic drug in countries such as France), and it is not authorized as an antidepressant in many countries. consider that the balance between risks and benefits was at best slightly favorable. However, if it is sold in other ways, because has nootropic effects and improves memory . In our country, it has started to be marketed as an antidepressant in 2015, but other alternatives are usually used as first line treatment.
- You may be interested: "Types of antidepressants: characteristics and effects"
Mechanism of action
Tianeptine is a unique antidepressant due to its peculiar mechanism of action. And is that unlike other popular antidepressants such as SSRIs, which inhibit the reuptake of serotonin in such a way that increases the amount of this hormone in the brain, thianeptine works greatly enhancing reuptake.
Although it might seem that this mechanism of action is counterproductive, the truth is that thianeptine is effective in the treatment of depressive symptoms. And is that although the amount of serotonin in the synaptic space is recap, apparently also acts intensifying communication between neurons of serotonergic pathways . The drug itself does not seem to bind to any receptor.
It also reduces the levels of corticotropin and glucocorticoids, which makes it useful in the fight against stress. It also reduces the activity of the hypothalamo-pituitary-adrenocortical axis. It also helps increase the levels of acetylcholine in the brain (among other reasons because it reduces the level of serotonin). By last, it also seems to modify the functioning and transmission of glutamate , normalizing in situations of stress.
- Related article: "Types of neurotransmitters: functions and classification"
Applications and indications
Tianeptine is a psychotropic drug that has been used in different disorders and with different applications. The first and most remarkable is its indication in major depression and other depressive disorders, in which, as mentioned, it has an efficacy comparable to that of drugs as popular as SSRIs.
It is also very useful in the treatment of disorders linked to anxiety and even to somatic disorders, without also having any negative effect on the level of consciousness. It has been shown to be very useful for the treatment of stress, while also preserving the damage derived from its continued experience in areas such as the hypothalamus.
By last, Tianeptine is also marketed as a dietary supplement in some countries due to its ability to facilitate the increase of acetylcholine levels, which favors attention and learning and facilitates memorization and recall.
Side effects and contraindications
Tianeptine is a drug that has a considerable level of efficacy. Unlike other drugs, it does not cause sexual alterations or increase weight. It has not been detected that it generates arrhythmias or cardiac problems, and it is especially known that it does not generate drowsiness. However, its consumption can generate different side effects.
Among the side effects that we can find, tianeptine could generate dizziness and dizziness, tremor, abdominal pain, headache and cold symptoms . Also asthmatic crises, anorexia or loss of appetite, pains, palpitations, tachycardia, suffocation and asthenia. In subjects with a history of psychotic outbreaks, it may be easier for them to reappear. Also, one of the great risks of this drug is that it has a great potential to generate dependency, being able to reach the subject that consumes it to the addiction. This is one of the main factors by which its use has not been popularized and in fact it is not commercialized in different countries.
As main contraindications, it should be noted that should not consume this type of drug subjects who are consuming antidepressants of IMAO type , or before the application of an anesthetic. It is also contraindicated in subjects with addiction problems (although it is used in depressions that occur with alcoholism), subjects with positive psychotic symptoms and / or manic episodes. Pregnant women, nursing mothers or minors, as well as people with kidney problems should be very careful.
- 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). Tianeptina: why in Spain has it not been classified as a narcotic? Rev. Psiquiatr. Health; ent; 9 (3): 176-177.