Tianeptine is a drug used primarily in the treatment of major depressive disorder, although it may also be used to treat asthma or irritable bowel syndrome. Chemically it is a tricyclic antidepressant (TCA), but it has different pharmacological properties than typical TCAs as recent research suggests that tianeptine produces its antidepressant effects through indirect alteration of glutamate receptor activity (i.e., AMPA receptors and NMDA receptors) and release of BDNF, in turn affecting neural plasticity.

Tianeptine has antidepressant and anxiolytic (anti-anxiety) properties with a relative lack of sedative, anticholinergic and cardiovascular adverse effects, thus suggesting it is particularly suitable for use in the elderly and in those following alcohol withdrawal; such persons can be more sensitive to the adverse effects of psychotropic drugs. Recent results indicate possible anticonvulsant (anti-seizure) and analgesic (painkilling) activity of tianeptine via immediate or downstream modulation of adenosine A1 receptors (as the effects could be experimentally blocked by antagonists of this receptor).

Tianeptine is a tricyclic antidepressant. Its antidepressant mechanism is different from the traditional tricyclic antidepressants. It can increase the reuptake of 5-HT in synaptic space, and may have the effect of improving the conduction of 5-HT neurons. It has no affinity for cholinergic or adrenergic receptors. Antidepressant effect is similar to tricyclic, but tolerance is better than tricyclic. In animal experiments, it can increase the spontaneous activity of pyramidal cells in hippocampus and accelerate the recovery of their function after inhibition; chemical book can increase the resorption of serotonin by neurons in cerebral cortex and hippocampus. The absorption of tianeptine sodium in digestive tract was rapid and complete. Ppb, as high as 94%. In the liver, it was metabolized completely by β - oxidation and N-demethylation, and the T1 / 2 of terminal clearance was short, which was 2.5 h. a very small amount of prototype drug (8%) was excreted from the kidney, mainly its metabolites were excreted from the urine. T1 / 2 clearance was prolonged for 1 hour in patients with renal insufficiency.

It is used to treat mild, moderate or severe depression, neurogenic and reactive depression, anxiety and depression of body, especially gastrointestinal discomfort, and anxiety and depression of alcohol dependent patients during abstinence. The recommended dose is 12.5mg TID before the main meal in the morning, middle and evening. In chronic alcoholism patients, no matter whether they have liver cirrhosis or not, there is no need to adjust the dose. For patients over 70 years old and with renal insufficiency, the dose is limited to 2 tablets per day.

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