Tianeptine: An Atypical Antidepressant with Multimodal Pharmacology

摘要

Background: Tianeptine is an atypical antidepressant marketed as Stablon since the late 1980's. While chemically very similar to tricyclic antidepressants, tianeptine was thought to have the apparently paradoxical mechanism of action of enhancing serotonin reuptake. However, recent data highlight a multimodal pharmacology for tianeptine including actions at glutamatergic synapses (inhibiting NMDA receptors and an indirect effect on AM-PA receptors) coupled with agonist effects at mu opioid receptors (mu-receptors).Objective: We have reviewed clinical and preclinical data for tianeptine to provide a comprehensive study of its pharmacology.