The effects of paroxetine and tianeptine on peripheral biochemical markers in major depression
Muck-Seler D, Pivac N, Sagud M, Jakovljevic M, Mihaljevic-Peles A.
Ruder Boskovic Institute, Division of Molecular Medicine,
PO Box 180, HR-10002 Zagreb, Croatia.
Prog Neuropsychopharmacol Biol Psychiatry. 2002 Dec;26(7-8):1235-43.


Depression is related to the alterations of the central serotonergic system and some antidepressants achieve their therapeutic effects through alteration of serotonin (5-HT) (re)uptake. Peripheral biochemical markers, platelet and serum 5-HT concentrations, platelet monoamine oxidase (MAO) activity, plasma levels of cortisol and prolactin (PRL), were investigated in patients with major depression before and after 4 weeks of treatment with paroxetine (an inhibitor of 5-HT uptake) or tianeptine (a stimulator of 5-HT uptake). Study was open, single center and included female depressed patients, 21 treated with tianeptine (37.5 mg/day) and 15 treated with paroxetine (20 mg/day), and 11 drug-free healthy women (controls). Before treatment, depressed patients as a group had significantly higher serum 5-HT and cortisol concentrations than healthy controls. There were no differences in the other biochemical markers. Response to antidepressant treatment was estimated according to the 50% fall in the initial scores of Hamilton Depression Rating Scale (HAMD) after 4 weeks of treatment. Good therapeutic response was observed in 47% and 45% patients treated with paroxetine and tianeptine, respectively. Paroxetine treatment induced significant decrease in platelet 5-HT concentrations in both responders and nonresponders, while no alterations in platelet 5-HT values were found in tianeptine-treated patients. There was a subgroup of depressed patients in paroxetine-treated group with high pretreatment platelet 5-HT concentration and later poor therapeutic response to paroxetine treatment. Serum 5-HT values, platelet MAO activity or plasma cortisol or PRL levels were unchanged after both treatments. The results suggest that pretreatment platelet 5-HT levels, but not other peripheral biochemical markers, might predict therapeutic outcome at least in paroxetine-treated patients.
Long-term use
Tianeptine (Stablon)
Tianeptine: structure
Melancholic depression
Paroxetine (Paxil, Seroxat)
Stress, memory and depression
Tianeptine for anxious depressives
Electrophysiological effects of tianeptine
Antidepressant comparisons: SSRIs v tianeptine
Plasma serotonin concentrations/antidepressants
Effect of tianeptine on plasma and platelet serotonin levels

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