Tianeptine, sold under the brand names Stablon, Tatinol, and Coaxil among others, is an atypical tricyclic antidepressant which is used mainly in the treatment of major depressive disorder, although it may also be used to treat anxiety, asthma, and irritable bowel syndrome. Tianeptine has antidepressant and anxiolytic effects with a relative lack of sedative, anticholinergic, and cardiovascular side effects. It has been found to act as an atypical agonist of the μ-opioid receptor with clinically negligible effects on the δ- and κ-opioid receptors. This may explain part of its antidepressant and anxiolytic effects; however, it is thought that tianeptine also modulates glutamate receptors, and this may also explain tianeptine's antidepressant/anxiolytic effects. Tianeptine was discovered and patented by the French Society of Medical Research in the 1960s. It was introduced for medical use in France in 1983. Currently, tianeptine is approved in France and manufactured and marketed by Laboratories Servier SA; it is also marketed in a number of other European countries under the trade name Coaxil as well as in Asia (including Singapore) and Latin America as Stablon and Tatinol but it is not available in Australia, Canada, New Zealand, Italy or the United Kingdom. In the United States, it is an unregulated drug sold under several names and some of these products have been found to be adulterated with other recreational drugs. It is commonly known by the nickname "gas station heroin". In July 2026, the United States Drug Enforcement Administration (DEA) announced its intention to make tianeptine a Schedule I controlled substance.
Medical uses
Depression and anxiety Tianeptine shows efficacy against serious depressive episodes (major depression), comparable to amitriptyline, imipramine and fluoxetine, but with significantly fewer side effects. It was shown to be more effective than maprotiline in a group of people with co-existing depression and anxiety. Tianeptine also displays significant anxiolytic properties and is useful in treating a spectrum of anxiety disorders including panic disorder, as evidenced by a study in which those administered 35% CO2 gas (carbogen) on paroxetine or tianeptine therapy showed equivalent panic-blocking effects. Like many antidepressants (including others Tricyclic antidepressant like Nortriptyline and Amitriptyline, Tetracyclic antidepressant, bupropion, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, Monoamine oxidase inhibitor among others) it may also have a beneficial effect on cognition in people with depression-induced cognitive dysfunction. , especially in elderly patients A 2005 study in Egypt showed tianeptine to be effective in men with depression and erectile dysfunction. Tianeptine has been found to be effective in depression, in people with Parkinson's disease, and with post-traumatic stress disorder for which it was as safe and effective as fluoxetine and moclobemide.
Other uses A clinical trial comparing its efficacy and tolerability with amitriptyline in the treatment of irritable bowel syndrome showed that tianeptine was at least as effective as amitriptyline and produced fewer prominent adverse effects, such as dry mouth and constipation. Tianeptine has been reported to be very effective for asthma. In August 1998, Dr. Fuad Lechin and colleagues at the Central University of Venezuela Institute of Experimental Medicine in Caracas published the results of a 52-week randomized controlled trial of asthmatic children; the children in the groups who received tianeptine had a sharp decrease in clinical rating and increased lung function. Two years earlier, they had found a close, positive association between free serotonin in plasma and severity of asthma in symptomatic persons. As tianeptine was the only agent known to both reduce free serotonin in plasma and enhance uptake in platelets, they decided to use it to see if reducing free serotonin levels in plasma would help. By November 2004, there had been two double-blind placebo-controlled crossover trials and an under-25,000 person open-label study lasting over seven years, both showing effectiveness. Tianeptine also has anticonvulsant and analgesic effects, and a clinical trial in Spain that ended in January 2007 has shown that tianeptine is effective in treating pain due to fibromyalgia. Tianeptine has been shown to have efficacy with minimal side effects in the treatment of attention-deficit hyperactivity disorder.
Contraindications Known contraindications include the following:
Hypersensitivity to tianeptine or any of the tablet's excipients.
Side effects Compared to other tricyclic antidepressants, it produces significantly fewer cardiovascular, anticholinergic (like dry mouth or constipation), sedative and appetite-stimulating effects. Unlike other tricyclic antidepressants, tianeptine does not affect heart function. μ-Opioid receptor agonists (Opioid) can sometimes induce euphoria, as does tianeptine, occasionally, at high doses, well above the normal therapeutic range (see § Recreational use below) which makes them prone for abuse. As such, it is not recommended to use Tianeptine for patients with history of any substance abuse, especially in opioid use disorders. Tianeptine can also cause severe withdrawal symptoms after prolonged use at high doses which should prompt extreme caution when stopping treatment.
By frequency Sources:
Common (>1% frequency)
Uncommon (0.1–1% frequency)
Rare (<0.1% frequency)
Pharmacology
Pharmacodynamics
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