Tianeptine
STABLON
“Tie Neptune”
pinpoint pupils → opioid
What it isMu opioid agonist and glutamatergic modulator; depression outside the US.
Why this oneIt was long described as an atypical antidepressant before its mu agonism was recognized.
What limits it⚑ It is an opioid, and high-dose misuse of "gas station heroin" causes dependence and death. Not US-approved.
FDA-approved for
- depression (non-US)
Off-label
- depression (approved in Europe; sold illicitly in the US as "gas station heroin")
NO BOXED WARNINGS
Principal risk⚑ It is an opioid, and high-dose misuse of "gas station heroin" causes dependence and death
Classes and tags
Clinical profile
Defining liabilityDependence, withdrawal and overdose CNS depression