tianeptine / Generic mfg. - LARVOL DELTA

Perioperative Pain in the Era of Emerging and Unregulated Substances: Recognition, Risk Assessment, and Management. (PubMed, Curr Pain Headache Rep) - "Patients may be exposed intentionally or unknowingly to fentanyl and nitazenes, xylazine and medetomidine, kratom and concentrated 7-hydroxymitragynine products, tianeptine, phenibut, and other psychoactive substances. Perioperative planning should integrate physiologic findings with the limitations of toxicology testing and distinguish surgical pain from tolerance, withdrawal, opioid-induced hyperalgesia, and delirium. Awareness of a geographically variable and rapidly evolving drug supply is increasingly important for safe perioperative care."

Journal • Review • Anesthesia • Cardiovascular • CNS Disorders • Depression • Hypotension • Pain • Psychiatry

When Buprenorphine Was Not Enough: Methadone Treatment of Tianeptine Use Disorder. (PubMed, J Addict Med) - "Patients with tianeptine use disorder, and with use disorders resulting from regular use of substances characterized as nonopioid but with µ-opioid receptor agonist effects, may follow a similar clinical course to patients with OUD. This case highlights an emerging treatment gap for use disorders involving substances with clinically relevant µ-opioid receptor agonist effects that do not fall within the OUD-based OTP treatment framework."

Journal • CNS Disorders • Depression • Endocrine Disorders • Major Depressive Disorder • Mood Disorders • Psychiatry • Substance Abuse

Addiction Specialists' Knowledge About and Assessment Practices for Kratom, Phenibut, and Tianeptine. (PubMed, Subst Use Addctn J) - "Surveyed respondents attending a dedicated nootropics session at an addiction conference reported substantial knowledge gaps about kratom, phenibut, and tianeptine, yet consistently endorsed the need for greater regulation and research. Clinical assessment practices and educational strategies warrant further study."

Journal • CNS Disorders • Psychiatry

Self-Reported Tianeptine Experiences on Reddit: Natural Language Processing-Assisted Qualitative Study. (PubMed, JMIR Infodemiology) - "This study, using natural language processing and manual thematic analysis of Reddit posts, revealed a rapid rise in discussions about tianeptine, with posts frequently reporting dependence, withdrawal, and coingestion with other unregulated substances, highlighting tianeptine as an emerging public health concern."

Journal • Substance Abuse

Monitoring novel psychoactive substance trends on social media: Analysis of discussions and dashboard implementation. (PubMed, Drug Alcohol Depend) - "Reddit-based surveillance provides timely and complementary signals to traditional forensic systems for NPS monitoring. Interactive visualizations and downloadable aggregated statistics are available via our dashboard."

Journal

Management of a Kratom and Tianeptine Overdose. (PubMed, J Pharm Pract) - "Symptomatic management, naloxone administration, and ICU-level supportive care led to gradual clinical improvement. This case highlights the potential for severe respiratory and neurological compromise with combined kratom and tianeptine toxicity."

Journal • CNS Disorders • Depression • Psychiatry • Respiratory Diseases

Tianeptine misuse and addiction: A systematic review of withdrawal, toxicity, and clinical management. (PubMed, Drug Alcohol Depend) - "Tianeptine misuse is associated with opioid-like dependence, withdrawal, and toxicity. Continued clinical and epidemiological observation is warranted."

Journal • Review • Addiction (Opioid and Alcohol) • CNS Disorders • Critical care • Depression • Psychiatry • Respiratory Diseases

Alignment between physician and patient perceptions of antidepressant treatment outcomes in routine clinical practice. (PubMed, Sci Rep) - "This observational, cross-sectional, multicentre study conducted in routine clinical practice compared physicians' and patients' opinions on antidepressant treatment outcomes following real-world use of tianeptine...The findings indicate a high degree of physician-patient concordance in global evaluations of antidepressant treatment outcomes under routine clinical conditions, alongside domain-specific differences in tolerability assessments. These findings highlight the importance of incorporating patient-reported perspectives when evaluating treatment experience in depression."

Journal • CNS Disorders • Depression • Psychiatry

Kava (Piper methysticum) consumption patterns and conceptualizations: results from an online survey. (PubMed, Subst Abuse Treat Prev Policy) - "Kava use practices are diverse, though perceived kava effects appear mostly mild. The proliferation and diversification of kava products pre-mixed with other psychoactive botanicals requires study as the benefit-risk profile may change. Clinicians should be aware of kava use for harm-reduction and other purposes."

Journal • Anesthesia • Mood Disorders • Psychiatry

Dose-response relationship of tegileridine in inhibiting the response to laryngeal mask airway insertion during etomidate induction in elderly patients: A sequential trial. (ChiCTR) - P=N/A | N=40 | Recruiting | Sponsor: The second hospital & clinical medical school.lanzhou university; The second hospital & clinical medical school.lanzhou university

New trial • Anesthesia

Tianeptine Misuse, Dependence, and Clinical Management: Three Case Reports and Literature Review. (PubMed, Case Rep Psychiatry) - "Clonidine and other medications used for opioid withdrawal may also be beneficial. This report presents three cases of tianeptine misuse, detailing their presentation, withdrawal symptoms, and treatment, including pharmacological interventions and treatment setting. We further highlight the problems associated with misuse, the unique presentation of the disorder, treatment options for substance use disorder due to another substance (tianeptine), and the urgent need for regulatory oversight."

Journal • Anesthesia • CNS Disorders • Depression • Gastrointestinal Disorder • Mood Disorders • Psychiatry • Substance Abuse

The atypical antidepressant tianeptine causes opioid-receptor-dependent beta oscillations in the rat hippocampus. (PubMed, Neuropharmacology) - "Injection of the opioid buprenorphine (0.03 mg/kg) had similar effects, but ketamine (10 mg/kg), another atypical antidepressant, caused a distinct pattern of LFP changes characterised by a naloxone-insensitive increase in slow-gamma activity...Injection of tianeptine also caused a reduction in the amplitude of the inhibitory 'tail' of the fEPSP, consistent with a blockade of feedforward inhibition. These results indicate that tianeptine, like several other atypical antidepressant drugs, enhances hippocampal beta/gamma-frequency LFP activity. This action is dependent on opioid-receptor activation and may depend on the disinhibition of principal neurons, a possibility that we are exploring."

Journal • Preclinical • Addiction (Opioid and Alcohol) • Anesthesia • CA3

ABM/COVMENT/2021: Randomized, double-blind, placebo-controlled trial of the efficacy and safety of tianeptine in the treatment of covid fog symptoms in patients after COVID-19 with the study of the pathophysiology of the phenomenon using positron emission tomography, biochemical, immunological and electrophysiological parameters (COVMENT). (clinicaltrialsregister.eu) - P1/2 | N=140 | Recruiting | Sponsor: Wojskowy Instytut Medyczny Panstwowy Instytut Badawczy | Not yet recruiting ➔ Recruiting

Enrollment open • Infectious Disease • Novel Coronavirus Disease

Improving Cognition in Bipolar Disorder: A Systematic Review of Current Pharmacological and Nutraceutical Approaches. (PubMed, Neuropsychobiology) - "These results suggest possible approaches for improving cognitive functioning in individuals with BD. Nevertheless, the inconsistency in outcomes and differences in study methodologies highlight the need for larger, rigorously controlled trials with uniform cognitive evaluations to confirm these findings and to assess their clinical relevance."

Journal • Review • Alzheimer's Disease • Bipolar Disorder • CNS Disorders • Cognitive Disorders • Mood Disorders • Psychiatry

Differential inhibition of the diverse behavioural effects of mu-opioid receptor agonists by progressive receptor depletion. (PubMed, Neuropharmacology) - "To investigate the contribution of receptor reserve and intrinsic efficacy to the in vivo effects of opioid agonists, we used the pseudo-irreversible MOR antagonist methocinnamox (MCAM) to progressively deplete functional MORs and examined the effects of three MOR agonists-morphine, 7-OH mitragynine, and tianeptine-across multiple behavioural assays in mice. Together, these findings suggest that differences in functional receptor reserve contribute to some, but not all, MOR-mediated behavioural outcomes. While reduced intrinsic efficacy and receptor reserve can partially explain separation between antinociception and certain adverse effects, additional ligand-dependent factors likely influence the expression of specific opioid-induced behaviours in vivo."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Constipation • Depression • Gastroenterology • Gastrointestinal Disorder • Pain • Psychiatry

μ Opioid Modulation of Sensorimotor Functional Connectivity in Autism: Insights From a Pharmacological Neuroimaging Investigation Using Tianeptine. (PubMed, Biol Psychiatry Glob Open Sci) - "Our findings suggest that μ opioid neurosignaling may contribute to functional brain differences in the sensorimotor network in autism. Given that sensorimotor system alterations are thought to be central to autism and contribute to other core autistic features, as well as adaptability and mental health, further research is warranted to explore the translational potential of μ opioid modulation in autism."

Journal • Autism Spectrum Disorder • Genetic Disorders

Prediction of 12-Week Remission in Patients With Depressive Disorder Using Reasoning-Based Large Language Models: Model Development and Validation Study. (PubMed, JMIR Ment Health) - "We analyzed data from 390 patients in the MAKE Biomarker discovery study who were undergoing first-step antidepressant monotherapy with 12 different medications, including escitalopram, paroxetine, sertraline, duloxetine, venlafaxine, desvenlafaxine, milnacipran, mirtazapine, bupropion, vortioxetine, tianeptine, and trazodone, after excluding those with uncommon medications (n=9) or missing biomarker data (n=32). Clinical evaluation by psychiatrists showed favorable mean ratings for correctness (4.3, SD 0.7), consistency (4.2, SD 0.8), specificity (4.2, SD 0.7), helpfulness (4.2, SD 1.0), and human likeness (3.6, SD 1.7) on 5-point scales. These findings demonstrate that reasoning-based LLMs, particularly when enhanced with research-informed prompting, show promise for predicting antidepressant response and could serve as interpretable adjunctive tools in depressive disorder treatment planning, although prospective validation in real-world clinical settings remains..."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

Targeting Cend1-Atp5f1b interaction rescues mitochondrial dysfunction and ameliorates ischemic brain injury. (PubMed, Commun Biol) - "Furthermore, screening identified the small-molecule compound Tianeptine (TNT), which stabilizes Cend1 dimers, elevates ATP levels, and confers neuroprotection in a Cend1-dependent manner. Notably, TNT's efficacy was abolished in Cend1 KO mice, highlighting its reliance on Cend1. The findings support the Cend1/Atp5f1b interaction as a potential mitochondria-targeted mechanism, offering innovative strategies to combat ischemic stroke by enhancing bioenergetic resilience."

Journal • Cardiovascular • CNS Disorders • Ischemic stroke • Metabolic Disorders • Reperfusion Injury • Vascular Neurology

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