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Noah, tianeptine is not FDA approved for use in the US, so it is not a medicine that US psychiatrists use except under special circumstances.
In general, it is a tricyclic antidepressant, yet does not appear to cause the same degree of cognitive disturbance, abuse potential, or disturbance in sexual functioning that other tricyclics can cause.
The efficacy data suggest that it is probably as efficacious as most SSRI's and and other tricyclics. However, there is nothing in the data that suggests it has any advantage over other agents currently available in the US. Furthermore, the manufacturer apparently doesn't believe it that it has any advantages that would allow it to make any headway in the VERY lucrative US market, and thus have not been willing to pay for FDA clinical trials.
One caviat: there is a general belief in the concept that someone's genetic coding predisposes them to be "responders" or "non-responders" to various drugs within a class. Thus, any given individual may not respond to a drug that has tremendous efficacy with the majority of patients who take it, and any given individual may respond like gangbusters to an agent that has poor efficacy for most patients who take it. In the end, the only important question is "how does it work for you?" If you are not currently on the drug, the data suggest that there are probably more promising options out there.
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why are you wearing that stupid man suit?
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