Clinical and neurobiological effects of tianeptine
and paroxetine in major depression
by
Nickel T, Sonntag A, Schill J, Zobel AW, Ackl N, Brunnauer A,
Murck H, Ising M, Yassouridis A, Steiger A, Zihl J, Holsboer F.
J Clin Psychopharmacol 2003 Apr;23(2):155-68

ABSTRACT

Selective serotonin reuptake inhibitors (SSRIs) are widely used as effective pharmacological agents to treat depressive disorders. In contrast to the SSRIs, which block the presynaptic serotonin (5-HT) transporter and by this route increase the concentration of serotonin in the synaptic cleft, the antidepressant tianeptine enhances the presynaptic neuronal reuptake of 5-HT and thus decreases serotonergic neurotransmission. Both SSRIs and tianeptine are clinically effective; however, their opposite modes of action challenge the prevailing concepts on the need of enhancement of serotonergic neurotransmission. To better understand the differences between these two opposite pharmacological modes of action, we compared the changes induced by tianeptine and paroxetine on psychopathology, the hypothalamic-pituitary-adrenocortical (HPA) system, and cognitive functions in a double-blind, randomized, controlled trial including 44 depressed inpatients over a period of 42 days. Depressive symptomatology significantly improved in all efficacy measures, with no significant differences between tianeptine and paroxetine. There was a trend toward better response to the SSRI among women. Assessment of the HPA system showed marked hyperactivity before the beginning of treatment, which then normalized in most of the patients, without significant differences between the two antidepressants. Cognitive assessments showed no significant differences between the two drugs investigated. The results of the current study suggest that the initial effect, i.e., enhancement or decrease of 5-HT release, is only indirectly responsible for antidepressant efficacy, and they support the notion that downstream adaptations within and between nerve cells are crucial. The normalization of the HPA system as a common mode of action of different antidepressants seems to be of special interest.

Serotonin
Paroxetine
Tianeptine.com
Tianeptine: review
Tianeptine and stress
Tianeptine compared
Tianeptine: structure
The tinaptine mystery
Tianeptine and memory
Tianeptine: side-effects
Tianeptine and dopamine
Tianeptine for autistic kids
Tianeptine and alcohol dependence
Tianeptine for asthmatic depressives
Tianeptine, amineptine and dopamine
Tianeptine (Stablon) v paroxetine (Paxil)
Tianeptine and the dopamine D2/D3 receptors
Tianeptine (Stablon, Coaxil): how does it work?

Refs
and further reading

HOME
HedWeb
Nootropics
cocaine.wiki
Future Opioids
BLTC Research
MDMA/Ecstasy
Superhapiness?
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family