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Tianeptine
Also known as: 66981-73-5, 72797-41-2, Tianeptine [inn], 7-[(3-chloro-6-methyl-5,5-dioxo-11h-benzo[c][2,1]benzothiazepin-11-yl)amino]heptanoic acid, (+)-tianeptine, (-)-tianeptine
Molecular Formula
C21H25ClN2O4S
Molecular Weight
437.0  g/mol
InChI Key
JICJBGPOMZQUBB-UHFFFAOYSA-N
FDA UNII
AKU7QFL9ZT

Tianeptine is a drug used primarily in the treatment of major depressive disorder and has been studied in the treatment of irritable bowel syndrome (IBS). Structurally, it is classified as a tricyclic antidepressant (TCA), however, it possesses different pharmacological properties than typical tricyclic antidepressants. Tianeptine was discovered and patented by The French Society of Medical Research in the 1960s. Currently, tianeptine is approved in France and manufactured and marketed by Laboratories Servier SA; it is also marketed in several other European countries under the trade name Coaxil as well as in Asia (including Singapore) and Latin America as Stablon and Tatinol but it is not available in Australia, Canada, New Zealand, the U.K. or the U.S.
1 2D Structure

Tianeptine

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
7-[(3-chloro-6-methyl-5,5-dioxo-11H-benzo[c][2,1]benzothiazepin-11-yl)amino]heptanoic acid
2.1.2 InChI
InChI=1S/C21H25ClN2O4S/c1-24-18-9-6-5-8-16(18)21(23-13-7-3-2-4-10-20(25)26)17-12-11-15(22)14-19(17)29(24,27)28/h5-6,8-9,11-12,14,21,23H,2-4,7,10,13H2,1H3,(H,25,26)
2.1.3 InChI Key
JICJBGPOMZQUBB-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CN1C2=CC=CC=C2C(C3=C(S1(=O)=O)C=C(C=C3)Cl)NCCCCCCC(=O)O
2.2 Other Identifiers
2.2.1 UNII
AKU7QFL9ZT
2.3 Synonyms
2.3.1 MeSH Synonyms

1. (3-chloro-6-methyl-5,5-dioxo-6,11-dihydrodibenzo(c,f)(1,2)thiazepin-11-yl)-7-aminoheptanoic Acid

2. Coaxil

3. Stablon

4. Tianeptine, (+-)-isomer

5. Tianeptine, Monosodium Salt

6. Tianeptine, Monosodium Salt, (+-)-isomer

2.3.2 Depositor-Supplied Synonyms

1. 66981-73-5

2. 72797-41-2

3. Tianeptine [inn]

4. 7-[(3-chloro-6-methyl-5,5-dioxo-11h-benzo[c][2,1]benzothiazepin-11-yl)amino]heptanoic Acid

5. (+)-tianeptine

6. (-)-tianeptine

7. Tianeptine (inn)

8. Tianeptine, (+)-

9. Tianeptine, (-)-

10. Aku7qfl9zt

11. Tpi-1062

12. Stablon (tn)

13. Jnj-39823277

14. 0t493yfu8o

15. Xv6773012i

16. 7-[(3-chloro-6-methyl-5,5-dioxido-6,11-dihydrodibenzo[c,f][1,2]thiazepin-11-yl)amino]heptanoic Acid

17. Tianeptina

18. S-1574

19. Tianeptine Acid

20. S-16190

21. S-16191

22. 191172-75-5

23. 1159812-13-1

24. 169293-31-6

25. 7-((3-chloro-6-methyl-5,5-dioxido-6,11-dihydrodibenzo[c,f][1,2]thiazepin-11-yl)amino)heptanoic Acid

26. 7-[(3-chloro-6,11-dihydro-6-methyl-5,5-dioxidodibenzo[c,f][1,2]thiazepin-11-yl)amino]heptanoic Acid

27. Heptanoic Acid, 7-((3-chloro-6,11-dihydro-6-methyl-5,5-dioxidodibenzo(c,f)(1,2)thiazepin-11-yl)amino)-, (+)-

28. Heptanoic Acid, 7-((3-chloro-6,11-dihydro-6-methyl-5,5-dioxidodibenzo(c,f)(1,2)thiazepin-11-yl)amino)-, (-)-

29. Heptanoic Acid, 7-((3-chloro-6,11-dihydro-6-methyldibenzo(c,f)(1,2)thiazepin-11-yl)amino)-, S,s-dioxide, (+)-

30. Tianeptina [inn-spanish]

31. Unii-0t493yfu8o

32. Tianeptineacid

33. (s)-tianeptine

34. Einecs 276-851-9

35. Tianeptine [mi]

36. Unii-aku7qfl9zt

37. Tianeptine [who-dd]

38. Schembl49293

39. (1)-7-((3-chloro-6,11-dihydro-6-methyldibenzo(c,f)(1,2)thiazepin-11-yl)amino)heptanoic Acid S,s-dioxide

40. Mls006010111

41. Gtpl7558

42. Tianeptine [nflis-drug]

43. Chembl1289110

44. Dtxsid7048295

45. Unii-xv6773012i

46. Chebi:91749

47. Chebi:190006

48. Chebi:190008

49. Hms3886a13

50. Bcp10101

51. Ex-a2724

52. Mfcd00865376

53. S5087

54. Zb1716

55. Akos015900590

56. Ac-2091

57. Ccg-269088

58. Cs-0433

59. Db09289

60. Ks-5099

61. (3-chloro-6-methyl-5,5-dioxo-6,11-dihydrodibenzo(c,f)(1,2)thiazepin-11-yl)-7-aminoheptanoic Acid

62. Hy-90003

63. Smr004701247

64. Ft-0630770

65. Ft-0675218

66. 23t172

67. C76315

68. D02575

69. A835601

70. A914696

71. Q424260

72. Q-100759

73. Brd-a53077924-236-01-4

74. 7-((3-chloro-6,11-dihydro-6-methyldibenzo(c,f)(1,2)thiazepin-11-yl)amino)heptanoic Acid S,s-dioxide

75. 7-[(3-chloro-6-methyl-5,5-dioxo-6,11-dihydro-5h-5lambda(6)-dibenzo[c,f][1,2]thiazepin-11-yl)amino]heptanoic Acid

76. 7-[(6-chloro-10-methyl-9,9-dioxo-9$l^{6}-thia-10-azatricyclo[9.4.0.0^{3,8}]pentadeca-1(15),3(8),4,6,11,13-hexaen-2-yl)amino]heptanoic Acid

77. 7-[[3-chloranyl-6-methyl-5,5-bis(oxidanylidene)-11h-benzo[c][2,1]benzothiazepin-11-yl]amino]heptanoic Acid

78. 7-{[(11s)-3-chloro-6-methyl-5,5-dioxido-6,11-dihydrodibenzo[c,f][1,2]thiazepin-11-yl]amino}heptanoic Acid

2.4 Create Date
2005-08-08
3 Chemical and Physical Properties
Molecular Weight 437.0 g/mol
Molecular Formula C21H25ClN2O4S
XLogP31.2
Hydrogen Bond Donor Count2
Hydrogen Bond Acceptor Count6
Rotatable Bond Count8
Exact Mass436.1223562 g/mol
Monoisotopic Mass436.1223562 g/mol
Topological Polar Surface Area95.1 Ų
Heavy Atom Count29
Formal Charge0
Complexity654
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count1
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Indication

Used primarily in the treatment of major depressive disorder and anxiety. It is currently being studied for fibromyalgia pain treatment.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Analyses in large-scale epidemiologic surveys have shown that the anxiety disorders are widely comorbid with major depression. This makes antidepressant with anxiolytic properties particularly unique and attractive. Tianeptine is effective in reducing depressive symptoms in mild to severe major depressive disorder and also alleviates anxious symptoms associated with depression without the need for coadministration of an anti-anxiety medication. These findings, however, are met with controversial data. In a study of healthy volunteers, Tianeptine-treated subjects were less accurate at identifying facial expressions, suggesting a lack of improvement in the psychomotor symptoms of depression. The tianeptine group also showed reduced memory and reduced attentional vigilance to various stimuli.


5.2 MeSH Pharmacological Classification

Antidepressive Agents, Tricyclic

Substances that contain a fused three-ring moiety and are used in the treatment of depression. These drugs block the uptake of norepinephrine and serotonin into axon terminals and may block some subtypes of serotonin, adrenergic, and histamine receptors. However, the mechanism of their antidepressant effects is not clear because the therapeutic effects usually take weeks to develop and may reflect compensatory changes in the central nervous system. (See all compounds classified as Antidepressive Agents, Tricyclic.)


5.3 ATC Code

N06AX14

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


N - Nervous system

N06 - Psychoanaleptics

N06A - Antidepressants

N06AX - Other antidepressants

N06AX14 - Tianeptine


5.4 Absorption, Distribution and Excretion

Absorption

Well absorbed, approximately 99% bioavailability.


Route of Elimination

Eliminated with bile as glucuronide and glutamine conjugates.


Volume of Distribution

0.8 L/kg (0.77 +/- 0.31 L/kg)


Clearance

Rapidly cleared by the kidneys.


5.5 Metabolism/Metabolites

Tianeptine is metabolized primarily by beta-oxidation of its heptanoic side chain. The metabolism of tianeptine was studied after a one-time oral administration of radioisotopically (14C) labeled compound to healthy male volunteers. After 1 week, approximately 66% of the dose was eliminated by the kidneys (55% elimination during the first 24 hr). After 24h, unchanged drug 3% of the drug was found unchanged in the urine. Three major metabolites result from beta-oxidation of Tianeptine. The metabolite profiles of tianeptine in feces and plasma were found to be qualitatively similar to that in urine.


5.6 Biological Half-Life

Approximately 2.5 h


5.7 Mechanism of Action

Recent studies suggest that tianeptine acts as a full agonist at the mu-type opioid receptor (MOR),. The mu opioid receptors are currently being studied as effective targets for antidepressant therapies. It is believed that the clinical effects of tianeptine are owed to its modulation of these receptors. In addition to its actions on the opioid receptor, previous studies have owed its action to its effect on the serotonin receptor,, dopamine (D2/3) receptors, and glutamate receptors,, as discussed below: Tianeptine has challenged the monoaminergic hypothesis of depression, as well as the widely supported monoaminergic mechanisms whereby the action of most known antidepressants have been explained. Specifically, this drug is thought to persistently alter glutamate receptor bursting of the hippocampal CA3 commissural associational synapse. Current research suggests that tianeptine produces its antidepressant effects through the modulation of glutamate receptor activity (for example, AMPA receptors and NMDA receptors) and affect the release of brain-derived neurotrophic factor (BDNF), which impacts neural plasticity. More recent studies by support the role of tianeptine in the modulation of glutaminergic activity in the amygdala, the emotional region of the brain associated with memories. Tianeptine reduces the hypothalamic-pituitary-adrenal response to stress, and thus prevents stress-related behavioral issues. In rodents, the stress of acute restraint increases extracellular levels of glutamate in the basolateral amygdala an effect that was inhibited by tianeptine. Interestingly, the SSRI fluoxetine increased extracellular glutamate levels in the basolateral amygdala regardless of stress conditions. These data demonstrate that the mechanism of action of tianeptine is distinct from SSRIs and support the hypothesis that the mechanism of action of tianeptine relates to alteration of glutaminergic activity in the amygdala and the hippocampus. In addition to the above mechanisms, tianeptine is a unique antidepressant and anxiolytic medication that stimulates the uptake of serotonin (5-hydroxytryptamine; 5-HT), and 5-hydroxyindoleacetic acid (5-HIAA) in brain tissue. Although the monoaminergic neurotransmitters serotonin (5-HT), noradrenaline (NA) and dopamine (DA) are proven to be related to the occurrence of depressive disorders, it is now recognized that monoamine deficits are not sufficient to explain the mechanism of action of antidepressant medications.


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