Future Uses of Tianeptine
You’re probably aware of Tianeptine’s successful usage as an anti-depressant and anti-anxiety medication. You may not know, however, just how versatile tianeptine is. In fact various pieces of research have suggested future uses for the drug ranging from the treatment of asthma through to prevention of erectile dysfunction. This article explores some of the biggest possible future usages of tianeptine as well as the science behind these possibilities.
A quick heads-up, this article assumes that you know what tianeptine is, its current usage as an anti-depressant and the possible mechanisms through which it works. (If not then check out this article to find out – insert link to prior article)
Tianeptine for the treatment of ‘at risk’ populations
One of the primary benefits of Tianeptine is that it has the same antidepressant and anti-anxiety properties[i] of other medications but with a relative lack of side effects. Specifically tianeptine does not have any cardiovascular, sedative or anticholinergic adverse effects that would have significant negative impacts on the elderly. Long term use of anti-cholinergic medication for example has been shown to increase the risk of both mental and physical decline.[ii] In older adults study results even suggest that anti-cholinergic drugs appear to increase the risk of death[iii] What’s more, there are also studies suggesting that they can contribute to memory problems[iv] including dementia.[v]
Studies have also shown tianeptine to be effective in the treatment of depression in individuals with post-traumatic stress disorder.[vi] In relation to PTSD, tianeptine was found to be most effective in chronic cases. It has additionally been proven to be at least as effective as moclobemide and fluoxetine[vii] yet far less dangerous in terms of side-effects and addiction potential. Fluoxetine, for example, has been shown to double an individual’s likelihood of developing insomnia, nausea, diarrhoea, rashes and itchiness as well as to increase likelihood of suicide or suicidal thoughts by 50-100%.[viii] This last point is especially concerning in the treatment of individuals with PTSD given that they present a high risk group for suicidal behaviours.
Tianeptine for the treatment of Asthma
Most anti-depressants cause an anti-inflammatory effect in bronchi. They have also been linked to bronchodilation. The sum of these effects is that anti-depressants could theoretically be useful in the treatment of severe asthma. However, traditional SSRI’s (Selective Serotonin Reuptake Inhibitors) come with complex side-effects that often outweigh the benefit of the asthma treatment. Moreover, as serotonin may indeed cause bronchoconstriction the drug may be self-cancelling. In other words traditional anti-depressants are ineffective in the treatment of asthma.
On the other hand “antidepressants that combine anti -inflammatory and bronchodilating properties with minor side effects could turn out to be promising drugs in treating asthma.” [ix] Tianeptine just so happens to be one of these drugs. Specifically tianeptine is useful because it actually enhances serotonin reuptake rather than inhibit it. This means that with tianeptine there is no bronchoconstrictive side-effect and it can work as a highly effective treatment for asthma.
Tianeptine as a treatment for asthma is much more than just hypothesis. In fact its effectiveness has been proven through numerous vigorous studies. In 1997, the Central University of Venezuela’s Institute of Experimental Medicine began a year-long randomized controlled trial of children with asthma. At the end of the trial the children who had received tianeptine all showed decreases in clinical rating of asthma as well as increased lung function.[x] Basically because tianeptine reduced free serotonin levels the bronchoconstrictive effects of that serotonin were reduced. This same institute went on to conduct two double-blind placebo-controlled crossover trials (about as scientifically vigorous as a study can get) as well as a seven year open-label study involving more than twenty-five thousand participants. Each of these studies demonstrated tianeptine to be highly effective in the treatment of asthma.[xi]
Tianeptine for the treatment of Irritable Bowel Syndrome
Tianeptine may also prove useful in the treatment of irritable bowel syndrome, especially in cases of severe abdominal pain for which amitriptyline would usually be prescribed ‘off-label’. A recent clinical trial[xii] compared the effectiveness and side effects of tianeptine and amitriptyline in the treatment of Irritable bowel syndrome as found them to be equally as effective. However, tianeptine produced significantly less side effects such as constipation and dry mouth. What’s more, amitriptyline has a much higher toxicity and can be particularly dangerous in overdose[xiii], meaning that tianeptine presents a safer alternative.
Tianeptine to treat pain due to Fibromyalgia
There have also been some promising developments in regards to tianeptine’s ability to treat pain associated with fibromyalgia.[xiv] Specifically a 24 week study in 2007 divided participants into a ‘treatment’ group and a placebo ‘control’ group. The study recorded pain scores, impact questionnaires, tender point scores and a depression anxiety inventory. They found that the group treated with tianeptine demonstrated noticeable reductions in pain, anxiety and negative impacts of fibromyalgia. With fibromyalgia still remaining a complex and poorly understood phenomenon any medications that can make headway in this area could prove extremely useful.
Tianeptine to treat Depression and Erectile Dysfunction
In 2006 the Journal of Sexual Medicine published original research on the topic of tianeptine for the treatment of depression and erectile dysfunction.[xv] The research was based on a placebo controlled double blind randomised study of 68 men over 8 weeks. The participants answered questionnaires on depression/anxiety, sexual inventory and quality of life/erectile function. The results of the study indicated that tianeptine was 72.7% successful in reducing depression, improving quality of life and reducing erectile dysfunction.
In Conclusion – A better alternative
You’ve probably noticed that the ailments tianeptine could treat in the future already have medications to treat them in the present. This has led some companies to question the drug’s worth. However, the future potential of tianeptine lies not in its ability to treat previously untreated ailments, but rather to BETTER treat ailments that we are already medicating today. Specifically, tianeptine appears to offer a safer treatment alternative with significantly less side effects than many of today’s more popular medications. As more awareness of tianeptine is generated there’s no doubt that its popularity will grow as a preferential medication for a variety of ailments.
[ii] Fox, C; Smith, T; Maidment, I; Chan, WY; Bua, N; Myint, PK; Boustani, M; Kwok, CS; Glover, M; Koopmans, I; Campbell, N (September 2014). “Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review.”. Age and ageing 43 (5): 604–15. doi:10.1093/ageing/afu096. PMID 25038833.
[iii] Ruxton, K; Woodman, RJ; Mangoni, AA (2 March 2015). “Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis.”. British journal of clinical pharmacology. PMID 25735839.
[v] “Study suggests link between long-term use of anticholinergics and dementia risk”. Alzheimer’s Society. 2015-01-26. Retrieved 2015-02-17.
[vi] Aleksandrovskiĭ IuA, Avedisova AS, Boev IV, Bukhanovkskiĭ AO, Voloshin VM, Tsygankov BD, Shamreĭ BK. ‘Efficacy and tolerability of coaxil (tianeptine) in the therapy of posttraumatic stress disorder’ https://www.ncbi.nlm.nih.gov/pubmed/16329631
[vii] Onder, E; Tural, U; Aker, T (April 2006). “A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake”. European Psychiatry 21 (3): 174–9. doi:10.1016/j.eurpsy.2005.03.007.PMID 15964747.
[viii] Stone MB, Jones ML (November 17, 2006). “Clinical Review: Relationship Between Antidepressant Drugs and Suicidality in Adults” (PDF). Overview for December 13 Meeting of Psychopharmacologic Drugs Advisory Committee (PDAC). FDA. pp. 11–74.
[ix] G Krommydas, K Gourgoulianis, V Raftopoulos, E Kotrotsiou. Antidepressants And Asthma Treatment. The Internet Journal of Pulmonary Medicine. 2005 Volume 6 Number 1.
[x] Lechin, F; van der Dijs, B; Lechin, AE (November 2004). “Treatment of bronchial asthma with tianeptine”. Methods and Findings in Experimental and Clinical Pharmacology26 (9): 697–701. doi:10.1358/mf.2004.26.9.872567. PMID 15632955.
[xii] Sohn, W; Lee, OY; Kwon, JG; Park, KS; Lim, YJ; Kim, TH; Jung, SW; Kim, JI (September 2012). “Tianeptine vs amitriptyline for the treatment of irritable bowel syndrome with diarrhea: a multicenter, open-label, non-inferiority, randomized controlled study”. Neurogastroenterology & Motility 24 (9): 860–e398. doi:10.1111/j.1365-2982.2012.01945.x. PMID 22679908.
[xv] Hany El-Shafey MD1, Ahmad Atteya MD2, Samir Abu el-Magd MD3, Ahmad Hassanein MD1, Ahmad Fathy MD1 andRany Shamloul MD, ‘Tianeptine Can Be Effective in Men with Depression and Erectile Dysfunction,’ The Journal of Sexual Medicine. Volume 3, Issue 5, pages 910–917, September 2006