tianeptine / Generic mfg. - LARVOL DELTA

Real-World Effects of Home-Based Transcranial Direct Current Stimulation in Depression: A Randomized Controlled Trial of 3-Week Versus 6-Week Protocols. (PubMed, Brain Behav) - P=N/A | "Both 3-week and 6-week active tDCS protocols were associated with improvements in depressive symptoms and cognitive function over time in this naturalistic clinical context; however, as the study did not include a sham control, these changes should be interpreted as comparative rather than causal effects. The 3- and 6-week protocols demonstrated similar therapeutic outcomes, suggesting that shorter courses may be sufficient. These findings support the real-world applicability of at-home tDCS and highlight the need to consider concurrent pharmacotherapy when evaluating tolerability and safety."

Clinical • Journal • Real-world evidence • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Real-world effects of home-based transcranial direct current stimulation in depression: a randomized controlled trial of 3-week vs. 6-week protocols (Neuroscience 2025) - "Tianeptine was the only drug significantly associated with increased adverse events (OR=6.073, 95% CI: 1.533-24.059, p=0.01); no associations were found for other medication classes... Home-based tDCS led to significant improvements in depressive symptoms and cognitive function. The 3- and 6-week protocols yielded comparable outcomes, suggesting shorter treatments may suffice. These results support the practicality of at-home tDCS and underscore the need to consider pharmacotherapy when evaluating safety."

Clinical • Real-world • Real-world effectiveness • Real-world evidence • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Emerging Substances and Perinatal Health: A Narrative Review. (PubMed, Obstet Gynecol) - "New exposures to substances include adulterants found in established drug supplies such as fentanyl, xylazine, nitazenes, and medetomidine, and substances promoted as herbal or natural supplements such as kratom and tianeptine. In addition, there are prescription medications being used in new or unintended ways, such as ketamine. This narrative review details some of the most common substances currently emerging in the United States and discusses the potential effects on pregnancy outcomes. It also highlights the importance of comprehensive inquiry into substance exposure and discussion regarding minimizing the risks of exposure in the setting of limited perinatal data."

Journal

Gas station heroin- tianeptine and its impact: a systematic review and exploratory analysis. (PubMed, BMC Public Health) - "Tianeptine misuse, characterized by escalating doses, habitual use, and co-administration with other substances, poses significant risks. Its easy availability and lack of regulation further exacerbate its public health impact. Targeted prevention, regulation, and treatment interventions are urgently needed to address these challenges."

Journal • Review • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Gas Station Heroin: A Case Report of Tianeptine Use Disorder and a Literature Review. (PubMed, Cureus) - "The patient declined referral to medication-assisted treatment, highlighting ongoing barriers to care. This case underscores diagnostic challenges when psychiatric symptoms mask underlying substance use disorders and emphasizes the urgent need for clinician awareness, patient education, and regulatory action."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry • Substance Abuse • Suicidal Ideation

Concomitant Tianeptine and Alcohol Use Disorders: Diagnosis and Treatment with Buprenorphine-Naloxone. (PubMed, Kans J Med) - No abstract available

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry

Tianeptine Products: Public Health Threat or Niche-Substance use? (PubMed, J Psychoactive Drugs) - "More within the tianeptine-use group believed they currently had any SUD (40.9% versus 20.2%, p = .0002), had ever been prescribed methadone/buprenorphine (27.3% versus 8.1%, p = .009), and were interested in recovery (72.7% versus 28.8%, p < .0001). Many tianeptine conceptualizations were unfavorable: "habit-forming" (68.2%), "addictive" (68.2%), "problematic" (59.1%); 86.3% believed overdose was possible. Tianeptine was used at low rates in this sample of adults who consumed gray-market supplements and included unfavorable perceptions."

Journal • Psychiatry

Antidepressants and the endogenous opioid system. (PubMed, Biochem Pharmacol) - "One strong line of evidence is that two different widely used antidepressants, tianeptine and ketamine, both interact with MOR; tianeptine as a full agonist, and ketamine as a positive allosteric modulator...Interestingly, proenkephalin is one of the most highly upregulated genes following long-term treatment of mice with fluoxetine, a selective serotonin reuptake inhibitor. Taken together, these findings suggest that the opioid system plays an important role in major depressive disorder. In this review, we discuss the strengths, problems, and limitations of the studies, as well as areas in need of further investigation."

Journal • Review • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • POMC-null Obesity • Psychiatry • Substance Abuse • PENK

Pharmacological and integrative Intervention in a complex case of recurrent depression with early trauma, dissociation, and persistent suicidal Ideation (ECNP 2025) - "Results Following the introduction of tianeptine 12.5 mg three times daily (TID), combined with sertraline (100 mg/day) and quetiapine (300 mg/night), the patient showed significant and sustained improvement over six months: -Suicidal ideation decreased from daily to episodic. Conclusions Tianeptine appears to be an effective and well-tolerated therapeutic option in complex depressive cases with trauma history and poor response to conventional pharmacotherapy. When integrated into a flexible, interdisciplinary, and relationally attuned care model, it not only improves symptom control but also facilitates deeper psychological work."

Clinical • CNS Disorders • Depression • Mood Disorders • Psychiatry • Suicidal Ideation

Should I test for Novel Psychoactive Substances (NPS) in Clinical Specimens? (PAINWeek 2025) - "Tianeptine is available in some states as “gas station heroin”. Carfentanil is a large animal tranquilizer and is 100 times more potent than fentanyl and 10,000 times more potent than morphine. Designer benzodiazepines are taken as an alternative to traditional benzodiazepines, such as alprazolam or diazepam... In total, 8384 specimens were positive for at least 1 NPS. The majority of positive specimens (64.7%) were positive for only 1 of the 6 NPS categories, while 26.2% were positive for 2 categories, 6.6% were positive for 3 categories, 2.4% were positive for 4 categories, and 0.1% were positive for 5 categories. Of the 8,384 specimens that were positive for at least 1 NPS, 52.9% were positive for an NPS in other illicit compounds; 44.3% were positive for designer fentanyl analogs; 21.5% for designer benzodiazepines; 17.6% for synthetic cannabinoids; 6.6% for designer opioids; and 4.0% for designer stimulants."

Clinical • CNS Disorders

Selective Chemometric Elimination of Co-Eluting Components in Chiral and Achiral Liquid Chromatographic Analyses. (PubMed, Anal Chem) - "Illustrative examples, including amino-acid and nicotine enantiomers, fungicides, and illicit street drugs such as tianeptine (which exhibits an overlapping impurity), were analyzed in isocratic and gradient runs with nonlinear baselines. Quantitation of extracted peaks from a real sample of street drug with overlapping impurities showed excellent calibration linearity, with an R2 value of 0.9997. For partially resolved peaks recovered from DeSC, we suggest using a generalized error-peak model for accurate area determination."

Journal

Successful symptom-based management of active withdrawal from multiple illicit benzodiazepines. (PubMed, BMJ Case Rep) - "Further history identified bromazolam, flubromazepam, alcohol, kratom, tianeptine and phenibut to be the predominant substances involved in his presentation...Symptom-based management was initiated using diazepam to stabilise the patient during active withdrawal...Current recommendations utilise equivalent benzodiazepine conversions and scheduled tapers. In the setting of unknown equivalents, physicians should prioritise symptomatic stabilisation to prevent poor outcomes."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Epilepsy • Psychiatry

The molecular mechanism of the protective effect of tianeptine against ovarian ischemia-reperfusion injury. (PubMed, Sci Rep) - "Under 60 mg/kg intraperitoneal (IP) ketamine and sevoflurane (inhaler) anesthesia, the right ovaries, fallopian tubes, and vessels in the OIR and TOIR groups were clamped by torsion. Tianeptine significantly suppressed oxidative stress and pro-inflammatory cytokine increases related with I/R in the ovarian tissue, while also alleviating histopathological damage and oxidative DNA damage. Our experimental results suggest that tianeptine treatment may be effective against I/R-induced ovarian injury."

Journal • Anesthesia • Cardiovascular • CNS Disorders • Depression • Oncology • Psychiatry • Reperfusion Injury • CAT • IL1B • IL6 • TNFA

Investigation into the Effects of Tramadol, Citalopram, Tianeptine, and Their Combinations on Rat Brain Tissue. (PubMed, Biomedicines) - " The tramadol + citalopram combination caused severe oxidative stress in brain tissue. Tramadol alone caused mild damage in brain tissue, whereas tianeptine prevented the brain damage caused by tramadol."

Journal • Preclinical • CNS Disorders • Solid Tumor • Vascular Neurology • CAT

CuF2-Catalyzed Chan-Lam Reaction of Saccharin: Solvent-Controlled Chemodivergent Synthesis of N-Arylsaccharin and Methyl 2-(N-Arylsulfamoyl)benzoates. (PubMed, J Org Chem) - "A saccharin-DMAP zwitterion complex was isolated, which provided crucial mechanistic insights for the product distribution. This chemodivergent synthesis transformed saccharin into versatile synthons for the synthesis of a tianeptine analogue and an endothelin antagonist analogue, highlighting its pharmaceutical relevance."

Journal

Tianeptine for Treatment Resistant Depression (clinicaltrials.gov) - P4 | N=38 | Terminated | Sponsor: Jonathan A. Javitch, MD, PhD | N=75 ➔ 38 | Trial completion date: Dec 2025 ➔ Aug 2024 | Recruiting ➔ Terminated | Trial primary completion date: Dec 2025 ➔ Aug 2024; Inadequate recruitment

Enrollment change • Trial completion date • Trial primary completion date • Trial termination • CNS Disorders • Depression • Mood Disorders • Psychiatry

Twining of Two Botanicals: Clinical Characteristics and Assessment Challenges of Kava and Kratom Use Among US Adults (CPDD 2025) - "Participants had to be >18 years old and endorse lifetime use of: kava, kratom, tianeptine, and/or akuamma seed... Kava consumers remain an understudied group with wide-ranging use motivations spanning recreation to harm-reduction. Further investigation is needed into kava use in bar settings and kava-kratom co-use."

Clinical • Addiction (Opioid and Alcohol) • Anesthesia • Mood Disorders • Psychiatry

Understanding Tianeptine: Breakthrough Treatment or Emerging Crisis? (APA 2025) - "Onset of Action • Faster therapeutic effects compared to SSRIs/SNRIs, making it a potential alternative in some clinical scenarios. Conclusion Tianeptine represents a dual-edged sword: an effective antidepressant with unique mechanisms of action and a high potential for abuse due to its opioid-like properties."

Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Gastrointestinal Disorder • Major Depressive Disorder • Mood Disorders • Pain • Psychiatry • Sleep Disorder

Did Serendipity Contribute to the Discovery of New Antidepressant Drugs? Historical Analysis Using Operational Criteria. (PubMed, Alpha Psychiatry) - "Selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine, citalopram, paroxetine, sertraline, and escitalopram), selective dopamine and noradrenaline reuptake inhibitors (bupropion), noradrenaline and serotonin reuptake inhibitors (venlafaxine, milnacipram, duloxetine, and desvenlafaxine), selective noradrenaline reuptake inhibitors (reboxetine), noradrenergic and specific serotonergic antidepressants (mirtazapine), melatonergic agonists (agomelatine), and serotonin modulators and stimulators (vortioxetine, vilazodone, tianeptine) correspond to the type IV pattern. Ketamine, a glutamatergic modulator, corresponds to the type III pattern, characterized by a non-serendipitous origin (initial development as an anesthetic agent) leading to a serendipitous observation (the discovery of antidepressant efficacy in individuals illicitly using). The majority of new antidepressants adhere to a type IV pattern, characterized by a rational and targeted design process where..."

Journal • Anesthesia

Tianeptine: enantiomeric separations, structural assignment, and biological interactions. (PubMed, Talanta) - "The total tianeptine and its enantiomeric ratio in recreational products were analyzed by HPLC-UV after developing a robust extraction procedure with ethanol for liquid and solid products. The assessment of the enantioselective binding of tianeptine to many essential proteins revealed higher affinity of human serum albumin for the S-tianeptine."

Journal • Addiction (Opioid and Alcohol)

Effects of tianeptine on mTORC1-mediated neuronal autophagy in primary rat hippocampal neurons under nutrient deprivation. (PubMed, Sci Rep) - "The aim of this study was to investigate the effects of the antidepressant tianeptine on the mechanistic target of rapamycin complex 1(mTORC1)-mediated autophagy pathway in primary hippocampal neurons exposed to B27-deprived conditions. In conclusion, tianeptine attenuated the activity of mTORC1-mediated autophagy in primary rat hippocampal neurons under B27-deprived conditions. These results may suggest a novel mechanism by which tianeptine may affect autophagy in neurons."

Journal • Preclinical • BECN1

In Response to Comment on "Tianeptine Exposures Reported to United States Poison Centers, 2015-2023". (PubMed, J Med Toxicol) - No abstract available

Journal

Comment on "Tianeptine Exposures Reported to United States Poison Centers, 2015-2023". (PubMed, J Med Toxicol) - No abstract available

Journal

Influence of antidepressant use on periodontal status: a systematic review and meta-analysis. (PubMed, Clin Oral Investig) - "This study informs health professionals that certain antidepressants may positively impact the periodontium, while also highlighting the need for further research evaluating their possible influence on the human periodontal condition and their potentially associated local/systemic adverse effects."

Clinical • Journal • Retrospective data • Review • Dental Disorders • Inflammation • Osteoporosis • Periodontitis

An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine Products in New Jersey - Case Series. (PubMed, J Med Toxicol) - "These cases represent a marked increase in tianeptine exposures compared with the poison center's historical average. Analytical testing revealed variable product composition, including the presence of synthetic cannabinoids. Clinicians should be aware that tianeptine containing products are widely available, unregulated, and can be adulterated."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Hypotension