Tianeptine

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Synonyms
Stablon, Coaxil, Za Za, Tianaa, Phrenze Red

Tianeptine, sold under the brand names Stablon and Coaxil among others, is an atypical 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 was discovered and patented by the French Society of Medical Research in the 1960s. 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, the United Kingdom, or the United States.

In 2001, Singapore’s Ministry of Health restricted tianeptine prescribing to psychiatrists due to its recreational potential.

In 2003, Bahrain classified it a controlled substance due to increasing reports of misuse and recreational use.

Between 1989 and 2004, in France 141 cases of recreational use were identified. The main reason for recreational use is to achieve an anxiolytic effect. According to Servier, stopping of treatment with tianeptine is difficult, due to the possibility of withdrawal symptoms in a person. The severity of the withdrawal is dependent on the daily dose, with high doses being extremely difficult to quit.

Official DEA statement states that the withdrawal symptoms in humans typically result in: agitation, nausea, vomiting, tachycardia, hypertension, diarrhea, tremor, and diaphoresis. Additionally there is a marked increase in calls to poison control centers related to tianeptine, an opioid-like drug, is of extreme public health concern. These data demonstrate that the abuse of tianeptine is increasing while contributing to the current opioid epidemic.

On 6 April 2018 Michigan became the first U.S. state to ban tianeptine sodium, classifying it as a schedule II controlled substance.

The Centers for Disease Control and Prevention (CDC) has expressed concern that tianeptine may be an “emerging public health risk”, citing an increase in exposure-related calls to poison control centers in the United States.

On March 13, 2020, with a decree approved by the Minister of Health, Italy became the first European country to ban tianeptine considering it a Class I controlled substance.

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