Tianeptine is a new presynaptic antidepressant with tricyclic structurally and modificated pharmacodynamic profile unlike other antidepressant agents. Tianeptine stimulates the uptake serotonin and reduces the Hypothalamic-Pituitary-Adrenal (HPA) response to stress. The antidepressant efficacy of tianeptine was show in major depression or bipolar depression disorders, with or without melancholia. Its also efficacy in dysthymic disorders and in depression that have as comorbidity anxiety. Its also used in elderly and in the depressive feature associated to alcoholic abstinence. Tianeptine is well tolerates up to one year being. Its collaterals most frequently: dry mouth, constipation, drowsiness, sweating, nausea (but in less rate that tricyclics). The insomnia and nightmares are not infrequent. Not significant anthicholinergic, cardiovascular and sedant effects makes it an alternative very important in the medical practice, in the elderly, and in the alcoholic patients. There are not death reported of overdoses by Tianeptine. We revise possibility hypothesis about its atypic antidepressant mechanism of action.