ANTIDEPRESSANT EFFECT OF TIANEPTINE - RECENT CLINICAL-TRIALS IN SUPPORT OF A NEUROCHEMICAL PARADOX

This review of recent controlled double-blind studies shows that tiane ptine is an effective antidepressant and that it relieves nonspecific mood disorder symptoms (anxiety, inhibition etc.) and somatic complain ts in depression. Tianeptine is also effective in anxiety- or alcohol- associated depression and in dysthymia. In endogenous melancholia, it induces the same percentage of responders as observed with classical a ntidepressants. The acceptability of tianeptine, especially in long-te rm use in at-risk patients such as elderly depressives or alcoholics, makes it a first-line, easy to use antidepressant. These clinical resu lts stress the neurochemical paradox of tianeptine, a 5-HT reuptake en hancer, which exhibits a mechanism of action totally opposite to 5-HT reuptake blockers. Since both mechanisms of action seem associated wit h therapeutic activity in depression several hypotheses are proposed t o explain these findings.