Scientists from Boston University have published evidence that the atypical antidepressant tianeptine potentially provides rapid and lasting neuropathic pain relief with a low risk of addiction.
The researchers from Boston University Chobanian & Avedisian School of Medicine in collaboration with the Icahn School of Medicine, Columbia University and the New York State Psychiatric Institute used experimental models to explore the cellular actions of tianeptine.
Neuropathic pain is a debilitating condition estimated to affect as much as 10% of the global population. Currently prescribed drugs, such as anticonvulsants and antidepressants, can have severe adverse effects, are not well-tolerated, take a longer time to work, and only help a subset of patients. Opioids come with the risk of physical dependence and addiction.
“We hope this revives the potential of using tianeptine for the treatment of chronic pain and associated conditions, such as anxiety and depression,” said Venetia Zachariou, corresponding author of the study and Professor and Edward Avedisian Chair of Pharmacology, Physiology & Biophysics at Boston University Chobanian & Avedisian School of Medicine. “By further refining this molecule, we could arrive at a pain treatment that is more effective, fast acting, and has a mild side effect profile.”
Use of RNA sequencing
Researchers used experimental models to investigate the persistent mechanical allodynia that is associated with damaged sciatic nerve, comparing the therapeutic profiles of tianeptine to that of the antidepressant desipramine.
The investigators used RNA sequencing to monitor gene expression changes in the nucleus accumbens, a brain region involved in motivation, addiction, and pain perception to identify pain-related genes that tianeptine treatment counteracts.
The results showed that tianeptine had profound pain-relieving properties that lasted well after the drug was no longer present, which suggested the drug affected the expression of genes that were critical for the maintenance of pain symptoms. The researchers also found that tianeptine started working more quickly than other antidepressants.
