Stablon/Coaxial (tianeptine-free acid for sale) is a drug used for the treatment of depression and anxiety. It is an atypical antidepressant. No form of the medication is currently approved for use in the United States due to its high risk for abuse and dependency. So, this is not a medication that can currently be prescribed by your doctor.
However, TIANEPTINE SODIUM is currently approved to treat depression and anxiety in France, some countries in Asia, and Latin America. In countries where it is used, it's marketed under the brand name Stablon. It's also sold in some countries under the brand names Platinol and Coaxial. The use of the drug has been rife with controversy since it was first introduced.
Please note that Stablon/Coaxial (tianeptine sodium) is not approved for use in the U.S. due to its high potential for abuse. This article is for information purposes only.
This paper will introduce the current situation, practical problems, and future development prospects of the drug.
The current application status of this product
Last week, Michigan's state legislature banned a drug you may not have heard of - an antidepressant called tianeptine sodium.
If approved by the governor, the bill will make Michigan the first state to classify the drug as a schedule 2 controlled substance.
Also this month, a report surfaced that two young people in Texas who had overdosed were found at the scene carrying bags marked with tianeptine and had excessive drugs in their blood.
They may be the first people in the United States to die from an overdose of tianeptine.
Tianeptine sodium was first listed in France in 1989 for the treatment of depression. It is an antidepressant approved by more than 60 countries. The United States is not one of them. It is sold under the names stable, coaxial, etc.
It is similar to a group of antidepressants called tricyclics dating back to the 1950s, but the role of tianeptine in the brain is different. It acts on μ Opioid receptors, i.e. targets morphine and oxycodone.
A credible source of opioid-linked science news was a 2014 paper by the Columbia University team.
It's amazing that no one knows what the goal is. It's a huge surprise, study co-author Jonathan Harwich, director of molecular therapy at Columbia University, told Healthline. This is the only antidepressant that works through this mechanism.
Javitch and others founded a biotechnology company called cures, which is developing variants of tianeptine and other opioid modulators for refractory depression. The team hopes to conduct human clinical trials as soon as possible.
Refractory depression is a huge problem, Ravitch said. Antidepressants targeting opioid receptors provide a unique opportunity to treat patients who are currently unresponsive to antidepressants.
Stablon / Coaxial and the possibility of its abuse
At present, tianeptine has not been approved for use in the United States, so it is strongly recommended not to use it for entertainment purposes. The FDA warned that the use of tianeptine, especially in large doses, could lead to serious side effects.
Many other countries that had initially approved tianeptine to treat symptoms of depression and anxiety have also followed suit. Although it's still available to be prescribed in France, in 2005, they added a label warning of the risk of abuse and dependence of tianeptine on the drug's pack. The benefit and risk ratio of the drug has also been reassessed a couple of times.
In Michigan and a few other states, tianeptine has been added to the list of dangerous controlled substances. Although the FDA doesn't approve it, tianeptine and products that contain the drug can still be bought in convenience stores, where it is marketed as a nootropic. Nootropics are synthetic supplements that people believe can enhance their mental performance. Drug regulatory agencies can't regulate them because they are marketed as dietary supplements.
A 2018 report found two fatal cases of tianeptine poison in Texas. However, the drug had been used recreationally and not as prescribed by a doctor or healthcare provider. In both cases, the casualties were found to have high levels of tianeptine in their blood.
The future of tianeptine sodium
This novel drug has helped change how scientists think about depression.
One reason is tianeptine has no direct effect on serotonin, unlike Prozac and other “SSRIs.” The basic theory about why antidepressants work has been moving away from the idea that depressed people have too little serotonin available to them, according to a 2017 review trusted
Depression instead may be caused by the brain becoming less adaptable and drugs may work when they promote “neuroplasticity.”
Tianeptine indirectly modulates glutamate, the main excitatory neurotransmitter. Stressful situations tend to affect glutamate pathways, leading to fluctuations that may degrade nerve and brain tissue. Tianeptine may protect those pathways and thus protect against stress.
Tianeptine has several advantages over SSRIs, a team led by Bruce S. McEwen at Rockefeller University write a trusted source in 2010. They said it may boost concentration within a week and “inner tension” within two weeks. They added it also works for anxiety as well as depression, is less likely to cause sexual problems or nausea, and doesn’t make patients groggy.
“The story of tianeptine is unfolding and this antidepressant is rich in future possibilities for understanding basic mechanisms as well as for its therapeutic applications,” they concluded.
Who might tianeptine help? Likely groups include people sensitive to social rejection, the elderly, Parkinson’s patients, and people with post-traumatic stress disorder (PTSD).
There is also evidence of potential genetic markers as well as brain scan signals that could help identify likely patients, Javitch and his co-author's not entrusted
A 2012 study found by trusted sources that tianeptine works as well for irritable bowel syndrome as the frequently prescribed amitriptyline, with fewer side effects.
Combining two antidepressants helps 50 percent to 60 percent of patients. In a 2013 study trusted source of 150 adult patients under age 65, using tianeptine as the add-on drug boosted the response rate to 65 percent.
Many patients now rely on an antidepressant and, for anxiety, a benzodiazepine.
“Benzos are worse” than tianeptine, Gupta told Healthline.
Still, she said she would be reluctant to ever prescribe tianeptine, even if it were approved in the United States, “because of the addictive potential.”
Tianeptine now represents a frontier in depression treatment.
“The discovery of the opiate mechanism is both very exciting and gives us pause,” Javitch said. “There’s a long history of thinking of a connection of physical pain and psychic pain. We know that endogenous opiate mechanisms are involved in regulating mood and behavior.”
However, despite what you might read online, there’s no clear scientific case that tianeptine boosts alertness, except perhaps by relieving anxiety, Javitch said.
It also isn’t a good painkiller. Any mild pain relief at a safe dose likely would wear off too quickly.
“What is remarkable about tianeptine is that it leads to lasting changes in the brain that mediate an antidepressant and antianxiety effect, long after the drug has been cleared from the body,” he said.