Meta tags:
description=Tianeptine ( Stablon ) : a neuroprotective, anxiolytic and mood-brightening opioid agonist and serotonin reuptake enhancer;
keywords=tianeptine, stablon, depression, antidepressants, serotonin;
author=dave@bltc.com;

Headings (most frequently used words):

-

Text of the page (most frequently used words):
the (218), tianeptine (125), and (110), for (38), may (34), are (32), but (31), that (23), depression (21), with (20), antidepressant (19), its (19), not (19), stress (19), can (18), this (18), effects (18), serotonin (18), has (17), ssris (17), use (16), their (16), mood (15), from (14), antidepressants (14), than (13), action (13), glutamate (13), also (13), induced (13), drug (12), been (12), have (12), effect (12), receptors (12), well (11), more (11), receptor (11), being (10), they (10), both (10), even (10), opioid (10), unlike (9), via (9), amineptine (9), chronic (9), stablon (8), less (8), drugs (8), high (8), other (8), when (8), many (8), patent (8), induce (8), side (8), dosage (8), dose (8), therapeutic (8), like (7), all (7), over (7), medicine (7), too (7), disorder (7), treatment (7), reuptake (7), into (7), clinical (7), does (7), selective (7), effective (6), depressive (6), disorders (6), such (6), yet (6), new (6), doesn (6), users (6), though (6), depressives (6), trials (6), might (6), some (6), there (6), nmda (6), least (6), increases (6), cortex (6), adhd (6), hippocampus (6), molecular (6), product (5), research (5), only (5), american (5), common (5), uncontrolled (5), will (5), hedonic (5), was (5), controlled (5), which (5), long (5), multiple (5), most (5), under (5), response (5), system (5), thus (5), useful (5), people (5), role (5), patients (5), plasma (5), because (5), one (5), tricyclic (5), depressed (5), dopamine (5), doses (5), syndrome (5), good (4), free (4), world (4), however (4), mechanisms (4), forms (4), brain (4), medical (4), pharmaceutical (4), social (4), against (4), post (4), genetically (4), psychoactive (4), used (4), term (4), way (4), indeed (4), despite (4), among (4), antagonists (4), monoamine (4), agonists (4), agent (4), delta (4), medication (4), sold (4), between (4), licensed (4), acutely (4), mechanism (4), possibly (4), due (4), life (4), inhibition (4), prescribed (4), performance (4), ssri (4), memory (4), acute (4), release (4), neurons (4), synaptic (4), amphetamine (4), children (4), option (4), understood (4), mao (4), thyroid (4), activity (4), sexual (4), serotonergic (4), reduces (4), emotional (4), notably (4), acts (4), malaise (4), typically (4), neuroprotective (4), how (4), pharmacies (3), servier (3), century (3), psychiatry (3), ill (3), revolution (3), illness (3), pleasure (3), responsible (3), prospective (3), need (3), human (3), really (3), perhaps (3), studies (3), few (3), reverses (3), fact (3), literature (3), chronically (3), years (3), decades (3), different (3), involved (3), environment (3), behaviour (3), personally (3), humans (3), first (3), hypothesis (3), inhibitors (3), agents (3), unfortunately (3), remission (3), rates (3), off (3), currently (3), increase (3), published (3), expired (3), status (3), state (3), america (3), known (3), pain (3), taken (3), symptoms (3), self (3), alcohol (3), similar (3), soon (3), dreams (3), cholinergic (3), dopaminergic (3), what (3), acid (3), day (3), 5mg (3), optimal (3), probably (3), needed (3), best (3), impair (3), cognitive (3), function (3), intellectual (3), non (3), tricyclics (3), anti (3), euthymic (3), deficits (3), inhibit (3), frontal (3), growth (3), hormone (3), secretion (3), tend (3), millions (3), itself (3), psychiatric (3), reported (3), central (3), type (3), brightening (3), properties (3), therapeutically (3), levels (3), important (3), nos (3), disease (3), poorly (3), damage (3), wider (3), agonist (3), fda (3), license (3), often (3), including (3), significance (3), treat (3), prozac (3), following (3), shell (3), region (3), feel (3), pituitary (3), basal (3), crf (3), acth (3), adrenal (3), excess (3), neurotransmitter (3), excitatory (3), kainate (3), ampa (3), nerve (3), any (3), cerebral (3), fatigue (3), french (3), marketed (3), citalopram (3), ibs (3), guide (2), about (2), 20th (2), very (2), route (2), still (2), brightener (2), whose (2), anglo (2), future (2), 21st (2), claim (2), sustained (2), activation (2), abuse (2), physiological (2), psychological (2), tolerance (2), never (2), gene (2), risk (2), parents (2), era (2), genomic (2), want (2), produce (2), babies (2), therapy (2), inevitably (2), aren (2), pathways (2), today (2), medicines (2), work (2), results (2), better (2), now (2), since (2), melancholic (2), associated (2), either (2), through (2), complex (2), part (2), remain (2), signalling (2), capacity (2), contemporary (2), researchers (2), neurogenic (2), variants (2), past (2), increasingly (2), just (2), neurochemical (2), wholly (2), encouraging (2), development (2), treatments (2), figures (2), moreover (2), them (2), were (2), actually (2), rodents (2), etc (2), hippocampal (2), ancestral (2), sub (2), panic (2), another (2), north (2), personal (2), prescription (2), widely (2), europe (2), latin (2), asia (2), healthcare (2), consumers (2), rather (2), lower (2), acting (2), association (2), asthma (2), reduce (2), asthmatics (2), anxious (2), considered (2), choice (2), heavy (2), drinkers (2), abstinence (2), anxiety (2), degree (2), without (2), breakdown (2), tends (2), occasionally (2), occurs (2), short (2), then (2), would (2), patient (2), mainly (2), standard (2), likely (2), rare (2), per (2), daily (2), psychotherapeutic (2), regimen (2), away (2), educationally (2), time (2), especially (2), consequence (2), pharmaceuticals (2), range (2), much (2), these (2), experiments (2), normally (2), anticholinergic (2), histamine (2), dementia (2), concentration (2), paxil (2), significant (2), antagonist (2), indirectly (2), acetylcholine (2), contribute (2), hasn (2), classic (2), dumb (2), presynaptic (2), experimentally (2), prevents (2), plasticity (2), single (2), rats (2), medial (2), paroxetine (2), improved (2), present (2), school (2), students (2), intensity (2), products (2), diagnostic (2), modern (2), nor (2), should (2), treated (2), potentially (2), based (2), beyond (2), evaluated (2), administration (2), promote (2), focus (2), existing (2), toxic (2), 2006 (2), elevated (2), during (2), partly (2), amygdala (2), inhibits (2), nitric (2), oxide (2), higher (2), heart (2), production (2), play (2), cousin (2), nucleus (2), accumbens (2), functional (2), enhanced (2), lifting (2), pursued (2), absent (2), smoother (2), certainly (2), stimulating (2), spectrum (2), user (2), relationships (2), subjective (2), noradrenergic (2), physicians (2), irritable (2), sedating (2), affinity (2), seen (2), obscure (2), vulnerable (2), cause (2), sense (2), unclear (2), trigger (2), fluoxetine (2), cellular (2), targets (2), forebrain (2), makes (2), contrast (2), diminished (2), relieving (2), misery (2), promoting (2), efficacy (2), regulate (2), opioids (2), interfering (2), cytokines (2), proposes (2), sickness (2), theory (2), analgesic (2), potential (2), corticotropin (2), releasing (2), factor (2), crh (2), turn (2), causes (2), cortisol (2), lateral (2), changes (2), evidence (2), neuronal (2), hpa (2), corticosterone (2), cell (2), amino (2), main (2), mediated (2), subtypes (2), entry (2), cells (2), critical (2), anaesthetic (2), limiting (2), mind (2), lacks (2), pathologies (2), sclerosis (2), viral (2), agomelatine (2), late (2), analogues (2), exists (2), isomer (2), relaunched (2), expensive (2), modafinil (2), vela (2), label (2), several (2), celexa (2), rate (2), kappa (2), salt (2), mail, dave, hedweb, com, info, manufacturer, source, united, monograph, 2018, pdf, international, 2025, quitting, reddit, wikipedia, structure, laboratories, superhappiness, bltc, search, further, reading, refs, wonderdrug, historically, remembered, minor, player, offers, crude, chemical, stopgap, suffering, unique, valuable, neglect, deserved, bright, smallpox, bold, extravagant, sounds, unhappiness, bequeathed, evolution, dismantled, biotech, unfolds, inadequate, stimulation, mesolimbic, 100, defeating, direct, exhibits, pure, palls, ethical, challenge, ahead, devise, autosomal, therapies, avoid, taboo, while, delivering, socially, lifetime, controversially, reproductive, choose, whether, susceptible, opt, ensure, heritable, offspring, our, set, point, raised, advocacy, prediction, across, lifespan, invites, emotive, talk, designer, scenarios, recipe, reproduction, genetic, roulette, preferable, lifelong, mental, super, health, worth, recalling, idea, surgery, once, judged, hopelessly, utopian, painless, cruelties, ethically, brave, enrichment, germline, functioning, mania, wireheading, neurostimulation, reward, centres, replaced, homeostatic, abolished, everybody, third, don, appreciably, respond, creative, clinicians, variety, monotherapy, failed, combine, lacking, hard, obtain, strongly, offer, comparable, protection, relapse, recurrence, anyone, ploughing, conclude, impossibly, inescapable, predicament, refractory, despair, subjected, dozen, undoubtedly, conditionally, activated, albeit, tragic, maladaptive, pointlessly, unpleasant, decade, ascendant, paradigm, eclipsing, older, dominant, forty, conceptualised, imbalance, nevertheless, immediate, isn, investigational, commercial, designed, combat, depressogenic, none, candidate, seriously, promise, raise, above, mediocre, dysfunctional, limits, proposed, convincing, detail, elucidate, reliably, beings, tormented, whereas, debateable, category, classed, decrease, neurogenesis, triple, glucocorticoid, crf1, pipeline, neuroplasticity, adaptive, types, allelic, genes, cured, hypercortisolaemia, cocktails, rosier, date, mercifully, moral, befell, had, unlicensed, americans, residents, lawfully, order, overseas, somewhat, bizarrely, gulf, bahrain, designated, substance, singapore, restricted, practising, psychiatrists, available, globally, net, prefer, cast, themselves, autonomous, disempowered, spirits, psychologically, robust, online, fast, bronchodilator, positive, severity, undergoing, attacks, atopic, prone, wracked, alcoholic, allergies, helpful, alleviates, signs, who, simply, drink, medicating, entails, reversion, switching, liquor, intoxication, subsequent, hangover, ethyl, consumption, marital, crimes, violence, aggression, alcoholics, withdrawal, insomnia, starting, subsides, vivid, paradoxically, posttraumatic, behind, altered, dreaming, patterns, unknown, reflect, rebound, hour, half, alternatively, neither, remodelling, driven, ptsd, profile, unusually, ask, troublesome, doubtless, naïve, adverse, league, tables, possible, crown, compliance, oxidised, reactive, rapidly, eliminated, kidneys, identical, heptanoic, chain, metabolism, steatosis, mice, mitochondrial, fatty, acids, beta, oxidation, microvesicular, metabolites, contender, benign, ranged, 25mg, 50mg, rarely, encouraged, explore, doctor, regrettable, individual, vary, lot, obviously, risks, advantages, titration, truly, personalised, meantime, everyone, temperamentally, equipped, perform, incremental, decreases, identify, works, pronounced, lag, ever, receive, psychotropic, matter, lifestyle, failure, exacerbates, poor, actual, ranges, 300, depend, animal, models, usual, horrible, measures, problematic, unstressed, cognition, complicated, consequent, antimuscarinic, aggravated, sedative, prior, contributed, misdiagnosis, seniors, typical, subtly, language, facility, healthy, young, aropax, subtle, dorsal, hippocampi, weakly, expected, borne, out, serve, counteracts, heteroreceptors, improves, working, reference, neurotrophic, restores, measurably, enhancers, clearly, maybe, subtler, battery, tests, measuring, improve, ht1b, desensitises, septal, nootropic, elevation, elderly, consolidation, moderately, treating, attention, deficit, hyperactivity, diagnosed, take, guises, innocent, sounding, labels, adverts, alluring, dextroamphetamine, salts, soar, confidently, summer, year, bouts, focused, argue, instruments, control, artefact, recognised, entity, cultures, where, compelled, sit, unnaturally, immobilised, classrooms, hours, each, performing, rituals, alien, feed, darkest, suspicions, advocates, elite, classifying, close, ties, consume, fairness, powerful, case, made, distress, pathologised, everyday, ultimately, lead, happier, commonly, curb, exuberance, crush, spirit, innumerable, purposes, welfare, paediatric, spirited, properly, attentional, worst, harmful, radical, alternative, stop, until, neurobiology, adequately, experimentation, cats, medicalisation, ritalin, companies, dsm, majority, critics, try, adderall, amphetamines, interestingly, show, reduced, susceptibility, oxidase, conceivably, sorts, smoke, inhibiting, easiest, risky, achieving, unselective, newly, transdermal, selegiline, patch, emsam, tobacco, coffee, triiodothyronine, hypothesised, supplementation, accelerate, elevating, sleep, deprivation, plays, here, quantifying, contribution, difficult, augment, enzyme, synthase, subcellular, distinct, normals, pathway, explain, using, ischaemic, coronary, disturbances, cardiovascular, significantly, normal, extracellular, responsiveness, supra, mildly, noticeably, tendency, escalation, gentle, stimulant, virtually, approved, divided, feels, relatively, massive, overdose, hazardous, cardiotoxic, relatives, safe, almost, pro, dampen, libido, dysthymia, subclinical, afflicted, individuals, partners, circle, friends, family, done, helped, save, intimate, broken, diminish, ardour, express, makeshift, correct, romantic, cautious, polypharmacy, authentic, melanocortin, bremelanotide, already, circulating, scientific, counterculture, veritable, brewing, ubiquitous, recreational, inhalable, sex, discourage, likelihood, cultural, 141, palatin, aphrodisiacs, love, ordinarily, give, rise, inner, tension, brighteners, boost, dispel, subjectively, harder, edged, texture, characteristic, anecdotally, wellbutrin, example, reputation, taking, irritability, impulsiveness, phobia, flatten, emotions, subsensitivity, archetypal, tofranil, finding, buffer, ideally, resilience, greater, sufficiency, swiftly, emptiness, apathy, exert, dulling, extent, emotion, deepening, sometimes, lived, soul, baring, releaser, sociabiliser, suggest, quite, result, muddied, dirtiest, symptomatic, modest, benefit, claimed, study, needs, autistic, discrimination, ghb, mdma, claude, rifat, blunting, incontinence, imipramine, ht1a, noradrenaline, mellow, bupropion, melancholia, motivation, density, innervation, categories, same, promotes, axons, layer, neocortex, limbic, structures, contains, ultimate, latent, architecture, medium, spiny, rostrodorsal, accumbal, essence, alive, experience, happiness, marked, feature, sadly, expression, substrates, misplaced, optimism, arises, conflated, marketing, ironically, banish, bliss, categorised, mainstream, western, comparison, putative, struggle, achieve, outcome, publication, bias, endemic, large, minority, continue, haunted, mrna, coding, proenkephalin, adrenals, gland, addictive, nonetheless, indirect, endogenous, sufferers, numerous, dysthymic, suffer, bodily, aches, defined, untreated, liable, exacerbate, combats, behavioural, proinflammatory, accompany, feelings, deep, hepatitis, instance, severe, generally, form, helps, euphoric, interferon, cytokine, somatic, opiate, met, enkephalin, tone, residual, academic, satellites, industry, worse, statistical, big, pharma, pushed, anhedonia, hotspot, converge, extension, population, remains, untested, knows, story, below, superseded, organism, perceives, secretes, adrenocorticotrophic, anterior, stimulates, glucocorticoids, persistent, physical, glands, dendritic, shrinkage, dendrites, current, suggests, prevent, reverse, neural, survival, normalise, hypothalamic, evoked, helping, cope, sensitivity, prolonged, programmed, death, temporal, dentate, gyrus, level, exerts, profound, serves, three, gated, ion, channel, methyl, aspartate, overstimulation, modulates, mediating, intracellular, amplitude, ratio, currents, dissociative, act, altering, deter, hand, psychotomimetic, sensible, analgesics, ketamine, normalising, phosphorylation, reportedly, apoptosis, transcription, stressful, contrasting, psychosocial, hypothalamus, indication, application, gleaned, various, patents, medicaments, neurodegenerative, ischaemia, traumatism, aging, alzheimer, amyotrophic, demyelating, encephalopathies, myalgic, encephalomyelitis, bacterial, infection, aids, double, blind, randomised, placebo, trial, spain, regular, unlikely, become, staple, orthodox, dentistry, cornucopia, possibilities, english, speaking, lay, public, early, novel, melatonin, ht2c, valdoxan, february, 2009, comprehensively, protected, teeth, fibromyalgia, us6599896, synthesised, 1981, antoine, deslandes, michael, spedding, developed, 1980s, secretive, privately, owned, innovative, giant, gain, raft, costly, regulators, habitually, sceptical, calibre, european, science, after, approval, could, cheaply, generic, competitors, commercially, seem, insoluble, problem, structurally, modified, patentable, exist, hetero, benzothiazepine, derivatives, commercialised, uncertain, superior, exploit, racemate, active, sister, design, chiral, allows, corporate, lawyers, extend, old, tired, 2002, finally, reach, usa, branded, guise, bowel, 2004, registered, march, corporation, acquired, preclinical, gains, prescribe, whatever, see, fit, prospect, pharmos, nuvigil, provigil, lexapro, suicide, dietary, intake, essential, tryptophan, precursor, synthesis, sertraline, zoloft, fluvoxamine, luvox, block, transporter, thereby, availability, synapse, primarily, host, indications, terminals, confounding, simplistic, low, theories, transporters, accelerates, presumably, depends, downstream, within, occurring, period, weeks, again, precise, adaptations, facilitates, inverse, correlation, announced, july, 2014, unexpected, discovery, full, negligible, hotspots, euphoria, dysphoria, dual, potently, anxiolytic, seemingly, unaccompanied, dependence, plagued, traditional, previous, light, neonatal, pregnancy, recently, popular, sulfate, readily, absorbed, excreted, body, sodium, allowing, dosing, concentrations, minimal, urgently, breakthrough, devastates, lives, coaxil, tatinol, lasting, caused, uniquely, puzzling, illustrates, little, understands, enhancer, neptune, fix, elixir, aka, gas, station, heroin,

Text of the page (random words):
naptic currents selective glutamate receptor antagonists including sub anaesthetic doses of the dissociative anaesthetic ketamine can act as analgesics and neuroprotective antidepressants despite dose limiting side effects their mind altering properties deter wider clinical psychiatric use tianeptine on the other hand is an analgesic and antidepressant that lacks psychotomimetic side effects at any sensible dose in theory tianeptine s neuroprotective action makes it a potential life extension drug for the wider euthymic population this hypothesis remains untested in prospective clinical trials chronic administration of tianeptine increases the density of serotonin innervation in the forebrain different categories of antidepressant may converge on the same molecular and cellular targets like ssris tianeptine promotes growth of serotonergic axons in the layer iv of the neocortex and forebrain limbic structures notably the shell region of the nucleus accumbens the shell region is important because it contains the ultimate hedonic hotspot of the brain latent in the architecture of medium spiny neurons in the rostrodorsal region of the medial accumbal shell is the molecular essence of pleasure and what makes it feel good to be alive by contrast anhedonia i e the diminished or absent capacity to experience happiness is a marked feature of clinical depression sadly today s antidepressants are more often effective at relieving misery than promoting expression of the molecular substrates of well being misplaced optimism over their therapeutic efficacy arises when rates of antidepressant response and remission are conflated in the medical marketing literature ironically agents that do banish depression and induce bliss notably mu opioid agonists are not categorised as antidepressants by mainstream western medicine by comparison the results from trials of putative antidepressants pushed by big pharma often struggle to achieve statistical significance the outcome of un published trials is normally worse publication bias is endemic to the drug industry and its academic satellites so a large minority of patients treated with antidepressants either continue to feel depressed or remain haunted by residual symptoms tianeptine itself has no affinity for the opioid receptors which regulate basal hedonic tone though it increases met enkephalin and mrna coding for proenkephalin in the adrenals and pituitary gland tianeptine s mood lifting action is not as effective or addictive as mu selective opioids tianeptine is nonetheless a useful medication for depressed ex opiate users it acts as an analgesic possibly via a serotonergic mechanism but possibly too via its poorly understood indirect effects on the endogenous opioid system the pain relieving action of tianeptine is especially important because many depressives are also chronic pain sufferers numerous other depressed and dysthymic people suffer bodily aches and an ill defined malaise when untreated somatic symptoms are liable to exacerbate depression tianeptine combats malaise partly by interfering with the cytokine induced behavioural and psychological effects of stress elevated proinflammatory cytokines accompany the chronic stress response cytokines typically trigger feelings of malaise and a deep sense of ill being a common side effect of interferon therapy of hepatitis c for instance is severe depression more generally the malaise theory of depression proposes that many forms of depressive disorder should be seen as a form of sickness behaviour tianeptine reverses sickness behaviour typically tianeptine helps its users feel well but not euphoric unlike its cousin amineptine tianeptine doesn t ordinarily give rise to a degree of subjective inner tension noradrenergic dopaminergic mood brighteners may boost motivation and dispel melancholia but subjectively such well being as they may induce is often of a harder edged texture than is characteristic of tianeptine anecdotally people on the noradrenergic dopaminergic antidepressant bupropion wellbutrin for example have a reputation among their physicians for being irritable tianeptine users are more likely to be mellow taking tianeptine reduces irritability and impulsiveness it s also a treatment option in panic disorder and social phobia tianeptine reduces acute stress induced noradrenaline release in the frontal cortex unlike most tricyclics tianeptine doesn t have a sedating action because it has no affinity for the histamine receptors nor does tianeptine tend to flatten emotions like the ssris unlike the ssris tianeptine doesn t induce serotonin 5 ht1a receptor subsensitivity as seen with many other antidepressants including the archetypal tricyclic imipramine tofranil but the significance of this finding is obscure at their best ssris buffer the user against the effects of chronic uncontrolled stress ideally ssris promote resilience and greater emotional self sufficiency in the vulnerable they swiftly treat emotional incontinence but ssris can also cause emotional blunting long term ssri use may induce a sense of emptiness and apathy tianeptine doesn t exert this dulling action but the extent of the emotion deepening effect sometimes reported by e g claude rifat is unclear and possibly short lived tianeptine certainly doesn t trigger the emotional soul baring of a serotonin and dopamine releaser like mdma or a sociabiliser like ghb indeed drug discrimination studies suggest that some of its subjective effects in rodents may be quite similar to fluoxetine prozac though the significance of this result is muddied by the fact that prozac is the dirtiest and least selective of the ssris tianeptine has been used experimentally in the symptomatic treatment of autistic spectrum disorders a modest benefit has been claimed but this study needs following up unlike ssris and other serotonergic antidepressants tianeptine does not dampen libido or sexual performance indeed sexual function may even be enhanced depression dysthymia and the spectrum of subclinical depressive disorders damage not just millions of afflicted individuals but their partners and wider circle of friends and family unfortunately no controlled studies have been done on the effects of existing psychotherapeutic drug treatments on the user s personal relationships thus ssris have helped save many intimate relationships yet they have also broken them for ssris can diminish both the intensity of being in love and the ardour with which to express it one makeshift option is to correct ssri induced sexual and romantic deficits with cautious polypharmacy authentic aphrodisiacs like palatin s melanocortin agonist pt 141 bremelanotide are already circulating in the scientific counterculture and beyond a veritable cultural revolution may be brewing yet the likelihood of ubiquitous recreational use of inhalable sex drugs may discourage an fda product license unlike its pro sexual cousin amineptine tianeptine does not significantly inhibit the synaptic reuptake of dopamine when taken at normal doses but tianeptine does acutely increase extracellular dopamine concentration in the nucleus accumbens and at higher doses in the frontal cortex the functional responsiveness of dopamine d2 d3 receptors is also enhanced supra therapeutic doses of tianeptine are mildly stimulating and noticeably mood lifting but tianeptine is almost without a tendency to uncontrolled dose escalation rare chronic high dosage tianeptine use is pursued for a gentle stimulant effect that is virtually absent at approved and divided doses high dose tianeptine also feels smoother than high dose amineptine in common with the ssris tianeptine is relatively safe even in massive overdose it s certainly less hazardous than its cardiotoxic tricyclic relatives tianeptine inhibits activity of the enzyme nitric oxide synthase nos in the hippocampus this is an important subcellular signalling system for the glutamate nmda receptor nos inhibitors have distinct antidepressant properties nos levels are higher in depressives than euthymic normals the effects of tianeptine on the glutamate no pathway explain the improved cardiovascular status of tianeptine using patients with ischaemic heart disease there is a poorly understood association between coronary heart disease and depression disturbances in nitric oxide production may play a role in both triiodothyronine t3 levels in the amygdala are elevated during tianeptine use a central thyroid action has been hypothesised for many antidepressant drugs and thyroid supplementation may augment and accelerate therapeutic response to antidepressants a thyroid mechanism may even be partly responsible for the mood elevating effects of acute sleep deprivation in depression though dopamine plays a role here too but quantifying the contribution of a thyroid mechanism to tianeptine s therapeutic effect is difficult interestingly rats on tianeptine show reduced susceptibility to serotonin breakdown by central monoamine oxidase type a but not by mao type b such mao a inhibition may conceivably contribute to tianeptine s mood brightening effect but all sorts of agents e g coffee and tobacco smoke have potentially mood brightening mao inhibiting properties too perhaps the easiest and least risky way of achieving therapeutically effective unselective mao inhibition is via emsam the newly licensed 2006 transdermal selegiline patch tianeptine is reported to be moderately useful in treating attention deficit hyperactivity disorder adhd at present millions of mainly american school students diagnosed with adhd take amphetamines under different guises and innocent sounding labels amphetamine adverts can be alluring try adderall amphetamine dextroamphetamine salts and soar confidently into summer and the new year drug induced bouts of focused intensity may perhaps be educationally useful occasionally but critics argue that such products are prescribed at least in part as instruments of social control adhd itself may not wholly be a diagnostic artefact of modern medicine yet nor is adhd a recognised diagnostic entity in cultures where children aren t compelled to sit unnaturally immobilised in classrooms for 6 8 hours each day performing rituals alien to their ancestral environment as if to feed the darkest suspicions of anti psychiatry advocates the majority of the medical elite involved in classifying psychiatric disorders via dsm iv have close ties to the drug companies in consequence american children consume some 90 of the world s ritalin in fairness a powerful case can be made that all forms of distress should be pathologised and treated the medicalisation of everyday life may ultimately lead to a happier world but with adhd potentially toxic amphetamine based products are commonly ab used to curb the exuberance and crush the spirit of innumerable school students for purposes beyond the welfare of the paediatric patient the long term effects of tianeptine use on high spirited children have not been properly evaluated its administration is known to promote attentional focus in cats at worst tianeptine may be a less harmful option than existing amphetamine based drugs a more radical alternative might be to stop pharmaceutical experimentation on children until the neurobiology of adhd is adequately understood in common with amineptine but unlike classic tricyclic antidepressants tianeptine does not normally impair cognitive function on some measures memory consolidation and intellectual performance may be improved but this claim for humans is problematic at least in unstressed non depressives the effects of tianeptine on cognition are complicated most tricyclics have dumb drug anticholinergic effects consequent on their antimuscarinic action aggravated by their sedative action due to anti histamine effects their use in the elderly prior to the ssri revolution contributed to the misdiagnosis of dementia in depressed seniors typical tricyclics can subtly impair concentration language facility and memory even in the healthy and euthymic young among the ssris only paroxetine paxil aropax has significant anticholinergic effects but all ssris can induce subtle cognitive deficits tianeptine is not a cholinergic antagonist yet acute high dose tianeptine treatment does indirectly inhibit acetylcholine release in the dorsal hippocampi and frontal cortex this may weakly and indirectly contribute to acute mood elevation but it might also be expected acutely to impair intellectual performance however this hasn t been borne out in controlled experiments rather than being a classic tricyclic dumb drug tianeptine may serve as a long acting nootropic it counteracts serotonin induced inhibition of cholinergic medial septal neurons chronic tianeptine desensitises serotonin 5 ht1b presynaptic heteroreceptors which inhibit acetylcholine release experimentally tianeptine improves working and reference memory in depressed rats probably due to its neurotrophic action tianeptine prevents stress induced memory deficits and restores synaptic plasticity even a single dose of tianeptine measurably increases growth hormone gh secretion long term gh enhancers tend to improve intellectual performance clearly there is a need for more research in humans and maybe a subtler battery of tests measuring cognitive function dosage of tianeptine in most clinical trials has ranged from 25mg to 50mg per day currently 3 x 12 5mg 37 5mg daily is standard patients healthcare consumers are rarely encouraged to explore the optimal dosage of their prescribed psychotherapeutic agent by their doctor this is regrettable because individual optimal dosage regimen can vary a lot obviously there are risks as well as advantages to encouraging self titration a post genomic era of truly personalised medicine is probably decades away in the meantime not everyone is temperamentally or educationally well equipped to perform the incremental dosage increases or decreases over time that are needed to identify what regimen personally works best especially when there is a pronounced therapeutic time lag one consequence is that very few people ever receive their optimal dosage of psychotropic medication or for that matter lifestyle drug of choice this failure exacerbates the poor response and remission rates to antidepressant drugs and other psychoactive pharmaceuticals the actual therapeutic dosage range of tianeptine probably ranges from less than 12 5mg to as much as 300 mg daily but these figures depend on animal models and the usual horrible experiments the side effect profile of tianeptine is unusually benign to ask what licensed antidepressant has least troublesome side effects is doubtless naïve but if adverse side effect league tables were possible then tianeptine would be a contender for the pharmaceutical crown patient compliance is high tianeptine is oxidised into reactive metabolites and rapidly eliminated mainly by the kidneys tianeptine has an identi...