Tianeptine and paroxetine in major depressive disorder, with a special focus on the anxious component in depression: an international, 6‐week double‐blind study†

Abstract

Tianeptine (37.5 mg/day) and paroxetine (20 mg/day) were compared in a population of depressive patients without past or current history of co-morbid anxiety and/or important anxiolytic treatment. In a 6-week, double blind trial, the special focus was on anxious symptoms.Both drugs showed good efficacy on depressive symptomatology, assessed with MADRS and HDRS, but no difference was detected between tianeptine and paroxetine, for any assessment criterion. Despite the choice of selected depressive patients, without any co-morbid anxious disorder, anxiety scale scores at inclusion (HAMA and BAS) were appreciable but correlated poorly with depressive scores. Both tianeptine and paroxetine improved the apparent anxious component in depression. Tolerability of both drugs was good, although significantly better with tianeptine.Thus tianeptine and paroxetine are effective and safe treatments for major depression and may also act directly on the anxious component of the psychopathology. Copyright 2001 John Wiley & Sons, Ltd.

Neurobiology of mood, anxiety, and emotions as revealed by studies of a unique antidepressant: tianeptine

“…It rapidly alleviates anxious symptoms of depressed patients 34,39,[41][42][43][44][45][46] with no sedative-associated effects. 47 Tianeptine and other antidepressants share some common effects such as those on neurogenesis.…”

“…The efficacy of tianeptine has been established against placebo and reference antidepressants of different classes, mainly tricyclics and SSRIs. [32][33][34][35][36][37][38][39][40] In addition, tianeptine alleviates anxious symptoms associated with depression, 34,39,41-46 a property not associated with sedative effects. 47 The alleviation of inner tension is also more rapid than fluoxetine effects.…”

Tianeptine and fluoxetine in major depression: a 6‐week randomised double‐blind study

“…The antidepressant activity of tianeptine has been demonstrated in several short-term controlled trials versus placebo, imipramine, amitriptyline, fluoxetine, paroxetine and sertraline (Cassano et al, 1996;Costa e Silva et al, 1997;Guelfi et al, 1989;Lôo et al, 1999;Waintraub et al, 2000;Lepine et al, 2001;Szádóczky and Füredi, 2000).…”

Efficacy of Tianeptine 25–50 mg in Elderly Patients With Recurrent Major Depressive Disorder

“…At the end of the 8-week mandatory period (or in cases of premature withdrawal if, in the investigator's opinion, this was advisable) the dose of escitalopram was gradually reduced during a double-blind tapering period of 1 week to avoid possible withdrawal reactions after the 8-week treatment period. Given that tianeptine is not associated with withdrawal symptoms, 32 there was no down-titration for tianeptine or placebo.…”

“…[28][29][30][31][32][33][34][35][36] Previous trials have also shown the efficacy and safety of tianeptine in elderly patients, including beneficial effects on cognitive performance. [37][38][39] However, a…”