Tianeptine belongs to antidepressants that have three cyclic rings in their structure – this group of drugs helps to increase the concentration of serotonin in the synapses of the central nervous system, thereby increasing the mood and improving the patient’s well-being. However, the antidepressant ttianeptine has a special effect – it can cause addiction.
The effect of tianeptine on the human body

The drug is available in the form of tablets and is taken orally. There are no injectable forms of tianeptine, since the substance practically does not dissolve in water.

When used in therapeutic doses, the drug eliminates the symptoms of depression of endogenous, exogenous origin or as part of bipolar disorder. The drug also helps to get rid of somatic manifestations of depressive disorder: headaches, abdominal pain, neuralgia, paresthesia.


Tianeptine is used to treat depression

At the heart of any depression is a decrease in the concentration of mediators, primarily serotonin and dopamine, in the synapses of neurons of the central nervous system. This may be due to a violation of their synthesis, accelerated destruction or excessive reverse capture by axons.

The drug coaxil blocks the reverse neuronal uptake of serotonin, which leads to an increase in the concentration of this mediator in synapses. As a result, depressive symptoms disappear, including somatic manifestations. The patient’s motivation for action increases, the mood rises.
Dependence on coaxil

According to the instructions for use, tianeptine should be taken 1 tablet (12.5 mg) up to 3 times a day. In this dosage, the drug has the desired antidepressant effect.

If the drug is administered at a dose tens of times higher than the therapeutic values, then a paradoxical morphine-like effect develops. Due to the excess of the permissible concentration of the drug, opiate receptors in the brain are stimulated, as with the introduction of morphine, heroin or opium.

Coaxil is the trade name of Tianeptine

This effect of coaxil at a certain stage began to be used by heroin addicts to eliminate withdrawal in conditions of drug deficiency. At the same time, tianeptine was often crushed and injected intravenously in the form of a suspension or synthesized by an artisanal method – all this led to the development of a mass of infectious, thromboembolic and other complications.
Signs of addiction

It should be understood that the use of coaxil in acceptable dosages is not capable of causing the development of drug addiction. The development of addiction to this drug occurs only in the case of its purposeful excessive introduction into the body.

As a rule, a similar situation develops in drug addicts with opioid addiction, who for one reason or another are unable to provide themselves with the usual drug (heroin, morphine, promedol, etc.). Primary tianeptine addiction is much less common.

There are no specific signs of a tianpetine “arrival”, the sensations from the introduction for the dependent resemble an injection of a small amount of an opioid drug. Withdrawal syndrome (withdrawal, withdrawal syndrome) is similar to that when opiates are canceled: diarrhea, constipation, vomiting, heart failure, increased blood pressure, panic attacks, sleep disorders. The most severe is the pain syndrome, which is manifested by arthralgias, myalgias, abdominal and headaches. In severe cases, during “withdrawal”, collapse, coma and death may develop.
Overdose and side effects

If the drug coaxil is taken orally to achieve narcotic intoxication, which is quite rare, then the main complications include: a disorder of the gastrointestinal tract, a violation of cardiac activity, fainting and, which is the most severe consequence, an withdrawal syndrome that is immune to any therapy.

Injection of tianeptine leads to much more serious complications.

Trophic ulcers of the extremities are caused by a violation of microcirculation due to infection and/or embolism of arterioles;
Abscesses of soft tissues, liver, lungs;
Aerobic and anaerobic gangrene;
Post – injection:
Infiltrates and abscesses at the injection site;
Acute thrombophlebitis of the head and neck, upper and lower extremities;
Thrombosis of the veins of the pelvis, thigh, lower leg, subclavian vein;
Limb artery thrombembolism;
Aneurysms, erosion of large arteries, bleeding from them.

All complications are associated with violation of the rules of asepsis and antiseptics with intravenous administration of the drug, as well as extremely low solubility of tianeptine in water.

Such conditions are often combined with hepatitis B, C, HIV infection, inherent in injecting drug addicts. This fact makes it extremely difficult to treat any infectious processes in the patient.


Treatment of dependence on coaxil

Unlike abstinence treatment after taking classical opiates, the usual therapy with naloxone or naltrexone only worsens the condition of tianpetine addicts. The fight against withdrawal syndrome is carried out by taking other antidepressants that selectively inhibit the reuptake of serotonin.

Fluoxetine or paroxetine are most often used. As part of symptomatic therapy, non-narcotic analgesics, hepatoprotectors, plasmapheresis are used.

Medical care for coaxil addiction

Abstinence almost always occurs in combination with infectious complications. They are eliminated surgically (opening and drainage of abscesses, phlegmon, amputations) and with the help of antibiotic therapy with broad-spectrum drugs (penicillins, cephalosporins).

Anticoagulants (heparin, warfarin) are used to combat thromboembolic complications.

After undergoing a course of drug treatment, long-term psychological rehabilitation follows, the fight against possible relapses of drug addiction.

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