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Coaxial (tianeptine) is an antidepressant from the group of tricyclic derivatives. The active substance is tianeptine. The mechanism of action of Coaxil is associated with increased reverse neuronal uptake of serotonin by neurons of the cerebral cortex and hippocampus. Increases the spontaneous activity of the pyramidal cells and increases the speed of their recovery after functional suppression.

By the nature of the effect on mood disorders, it occupies an intermediate position between sedative and stimulating antidepressants. In drug dispensaries, the effect of Coaxil in uncontrolled doses is compared with heroin.

For a long time, Coaxil was prescribed as one of the safest antidepressants, and was offered as a treatment for heroin addiction. One of the few antidepressants sold over the counter. In the instructions for use, to this day, in the item “Pharmacological properties”, it is written – “not addictive …”.

Thanks to the “brilliant” advertising company “Servier” Coaxil is known to a wide range of doctors and patients. Moreover, about the last two or three years, it is notorious …

The first patient with Coaxil addiction met in my practice about three years ago. For a long time, with special care, I clarified the history of the disease, complaints. Prior to Coaxil, the patient tried many drugs. But she preferred opiates. The state of intoxication and withdrawal of Coaxil also, as she said, was like with “opiates”. For the sake of justice, it should be noted that the dose (30 tablets per day) was ten times higher than the recommended in the instructions. When I told my colleagues at the clinic, at first they did not believe it. And when they believed, they began to consider casuistry, a misunderstanding. This first case began to be forgotten, but six months later a second appeared …

Serious scientific studies have not yet been published to explain why Coaxil, differing in its chemical structure and mechanism of action from opiates, causes a similar clinical picture of dependence, both in physical and mental manifestations. However, a rare narcologist is currently arguing with the fact of this “similarity.”

Of the distinctive features, according to my observations, it should be noted a somewhat longer period of formation of the “system” (2-4 weeks), the prevalence of headaches, depressive and psychopathic reactions in the structure of withdrawal syndrome. Among the effects on the structures of the body that are not associated with the central nervous system, severe thrombosis and thrombophlebitis are more common than heroin, often leading to gangrene and subsequent amputation of the limb. This occurs when Coaxil is administered intravenously.

Currently, many drug addicts use coaxil as a substitute for opium drugs, and it can be purchased quite legally in a pharmacy, and the process of preparing it for intravenous administration does not require time or any additional ingredients. But the most unpleasant in all of this is that, in addition to physical dependence, this drug causes a strong psychological dependence, and also has a destructive effect on the whole organism as a whole, and is much stronger than the same heroin or opium.

In 2006, in one of the pharmaceutical publications, he found information that Coaxil became the leader in sales in absolute monetary terms among all psychotropic drugs in Russia. In parallel with this, according to the journal of anonymous consultations of the Perspective rehabilitation program in 2006, the number of calls on the problem of dependence on Coaxil increased several times over the previous year. Coaxil lost only the heroin to the “heavy addiction” championship.

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