Antidepressant Medications as Opioid Agonists?

Mechanisms by which antidepressant medications work, especially atypical antidepressants, remain obscure. Tianeptine, an atypical tricyclic antidepressant with fast effects on cognitive and affective depressive symptoms, has demonstrated clinical efficacy for some patients whose depression is resistant to selective serotonin receptor inhibitors. The medication is not FDA approved. Tianeptine neither inhibits biogenic amine transporters nor binds to monoamine neurotransmitter receptors or transporters or to kainate receptors. Earlier studies suggest that it modulates glutamatergic transmission and NMDA and AMPA receptor function and that it restores stress-induced reduction of dendritic arborization in hippocampal neurons.

To identify tianept…