Based on the results of our investigation of patients with anxious depression under the treatment with serotonergic antidepressants with different mechanism of action on serotonin reuptake we, the first time in the literature, propose the hypothesis about neurochemical mechanism of tianeptine action. According to this hypothesis tianeptine not only activates serotonin reuptake into the synaptic ending but also activates its release from the ending into the synaptic cleft thus accelerating serotonin turnover rate in the synapse. Proposed mechanism mainly refers the first, acute phase of its action directed to the normalization of serotonergic neurotransmission.

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