Tianeptine sodium salt is a tricyclic antidepressant, and its antidepressant mechanism is different from traditional tricyclic antidepressants. It can increase the reuptake of 5-HT in the synaptic gap, and may improve the transmission of 5-HT neurons. No affinity for choline or adrenergic receptors. Antidepressant efficacy is similar to tricyclic, but the tolerance is better than tricyclic. In animal experiments, it can increase the spontaneous activity of hippocampal pyramidal cells and accelerate the recovery of their function after inhibition. It can increase the reabsorption of serotonin by neurons in the cerebral cortex and hippocampus. The absorption of tineptine sodium in the digestive tract is rapid and complete. Rapid distribution, PPB up to 94%. It is completely metabolized in the liver by β-oxidation and N-demethylation, clearance of terminal T1/2 is short, 2.5h, and a very small amount of the drug (8%) is excreted from the kidney, mainly its metabolites from the urine. Patients with renal insufficiency cleared T1/2 for 1h.

Drug interaction

1. Combined with monoamine oxidase inhibitors, cardiovascular attacks or paroxysmal hypertension, high fever, convulsions, and even death may occur. Monoamine oxidase inhibitors must be discontinued for 2 weeks before taking this product. After 24 hours of discontinuation of this product, you can take monoamine oxidase inhibitors.

2. Salicylate can reduce the plasma protein binding rate of this product, and should be reduced when combined. 

Precautions 

1. Use with caution for cardiovascular diseases, gastrointestinal diseases and severe renal insufficiency. 2. Patients with hereditary suicidal tendencies who are depressed must be closely monitored when taking this drug, especially at the beginning of treatment. 3. If general anesthesia is required, the anesthesiologist should be informed that the patient is taking this drug and stop taking it 24 or 48 hours before surgery. When emergency surgery is required, there is no withdrawal period, but preoperative monitoring should be performed. 4. As with all psychiatric drugs, if treatment is interrupted, the dose should be gradually reduced for more than 7 to 14 days. 5. Some patients will have decreased alertness. Drivers or machine operators should be aware of the risk of drowsiness when taking this drug. 6. Monoamine oxidase inhibitors must be discontinued for 2 weeks before starting treatment with this product. Patients who have been taking this product instead of monoamine oxidase inhibitors need only stop taking this product for 24 hours. 7. Animal experiments showed that this drug had no adverse effects on reproductive function, only a few drugs passed through the placenta, and no accumulation in the fetus was observed. However, there is no relevant clinical research data in humans, so avoid taking this drug during pregnancy. 8. Tricyclic antidepressants can be secreted into the breast milk, it is recommended not to breastfeed during the medication.