Interest in the abuse of tianeptine in the United States has been increasing over the past decade (1). The xenobiotic, which is known under the trade name internationally as Stablon or Coaxil, was historically touted for its efficacy as an antidepressant (2). While the chemical structure is similar to tricyclic antidepressants, pharmacodynamic research indicates that the drug increases serotonin reup-take and beneficial effects may be secondary to neuronal remodeling, increased neuronal plasticity, and modulation of cerebral dopamine concentrations (3,4). More recently, tianeptine's activity at the mu-opioid receptor has become an area of significant interest given its potential to lead to misuse (5).
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