Long-Term Administration of Tianeptine in Depressed Patients after Alcohol Withdrawal

Malka, Ronit; Lôo, Henri; Ganry, H.; Souche, A.; Marey, C; Kamoun, A

doi:10.1192/s0007125000296712

Cited by 30 publications

(14 citation statements)

References 14 publications

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“…There were no remarkable side effects in both groups. Tianeptine had no effect on hematology or serum biochemistry.Our results fit to those of Daoust et al (1992), reporting a significant decrease of alcohol intake in rats, and Malka et al (1992), who report good efficacy of tianeptine treating depressive patients after alcohol withdrawal, although the findings of Kranzler and colleagues (Kranzler et al, 1995) dashed hopes for the efficacy of serotonin-reuptakeinhibitors in treatment alcoholism. We conclude that tianeptine hold promise as a safe and effective adjunct to psychosocial alcohol rehabilitation program in adolescents.…”

supporting

confidence: 92%

Tianeptine May Be a Useful Adjunct in the Treatment of Alcohol Dependence of Adolescents

Niederhofer¹,

Staffen²,

Mair³

2003

Alcoholism Clin & Exp Res

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Although the mechanisms involved in craving and relapse in alcoholic patients are not known, an effective agent for relapse prevention would have great social and economic benefits. Several studies have reported promising results with opiate antagonists (Mason et al., 1994), acamprosate (Gual andLehert, 2001) and with drugs that affect transmission of serotonin (Naranjo and Kadlee, 1991), and dopamine (Shaw et al., 1994). Tianeptine induces an ex vivo increase of serotonin, uptake by the synaptosomes of the hippocampus and cortex (Mennini and Garattini, 1987). The activity profile and neurochemical characteristics of tianeptine suggest that the drug may be also suitable for use in alcoholic and depressed patients following alcohol withdrawal.We used the Michigan alcoholism screening test (Selzer, 1971) to assess the severity of alcoholism of 26 inpatients without serious coexisting diseases or receiving drugs acting on the central nervous system (after written informed consent). They were 16 -19 years of age, abstinent for at least 5 days before the study, with alcohol dependence of chronic or episodic type (DSM-IV criteria), whose yGT value was at least twice the upper limit of the normal range, and whose mean corpuscular volume was 93 fl or more. They were randomly assigned to tianeptine or placebo, while psychosocial treatment (psychotherapy three times a week, physiotherapy and ergotherapy) was started. Patients received 37.5 mg tianeptine or Placebo daily. They were classified as abstinent or relapsed according to his or her self-report 30 and 90 days after the first administration of tianeptine. We checked the red and white blood count, serum concentrations of sodium, potassium, chloride, calcium, phosphate, blood urea nitrogen, creatinine, uric acid, fasting blood glucose, alkaline phosphatase, total bilirubin, cholesterol, triglycerides, and albumin. There were no initial differences between tianeptine (n ϭ 13) and placebo groups (n ϭ 13) in quantity and frequency of drinking, and Hamilton depression scores.Although our sample of adolescents was relatively small and the time of abstinence was relatively short, our data show, that the proportion of patients who remained abstinent was higher in the tianeptine group than in the placebo group throughout the 90 days of treatment. On day 90, 2 of the placebo-treated patients, compared with 5 tianeptinetreated patients, had been continuously abstinent (MantelCox test; p ϭ 0.0063). Mean cumulative abstinence duration was also significantly greater in the tianeptine group than in the placebo group (69.2 [SD 38.3] vs 31.4 [17.9] days; p ϭ 0.012). There were no remarkable side effects in both groups. Tianeptine had no effect on hematology or serum biochemistry.Our results fit to those of Daoust et al. (1992), reporting a significant decrease of alcohol intake in rats, and Malka et al. (1992), who report good efficacy of tianeptine treating depressive patients after alcohol withdrawal, although the findings of Kranzler and colleagues (Kranzler et al., 1995) dashed ...

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supporting

confidence: 92%

Tianeptine May Be a Useful Adjunct in the Treatment of Alcohol Dependence of Adolescents

Niederhofer¹,

Staffen²,

Mair³

2003

Alcoholism Clin & Exp Res

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“…In clinics, patients treated with tianeptine have shown long-term improvement in depression and anxiety after alcohol withdrawal. 292 Moreover, tianeptine has been shown to be effective in preventing alcohol intake in alcoholics suffering from depression. 293 Together, these findings suggest that tianeptine might be used for the treatment of alcohol dependence associated with depression.…”

Section: Serotonergic System As a Potential Therapeutic Target In mentioning

confidence: 99%

Role of the Serotonergic System in Alcohol Dependence

Sari

Johnson

Weedman

2011

Progress in Molecular Biology and Translational Science

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Alcohol dependence remains among the most common substance abuse problems worldwide, and compulsive alcohol consumption is a significant public health concern. Alcohol is an addictive drug that alters brain function through interactions with multiple neurotransmitter systems. These neurotransmitter systems mediate the reinforcing effects of alcohol. Specifically, the serotonergic system is important in mediating alcohol reward, preference, dependence, and craving. In this review chapter, we first discuss the serotonin system as it relates to alcoholism, and then outline interactions between this system and other neurotransmitter systems. We emphasize the serotonin transporter and its possible role in alcoholism, then present several serotonergic receptors and discuss their contribution to alcoholism, and finally assess the serotonin system as a target for pharmacotherapy, with an emphasis on current and potential treatments.

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“…In patients, however, the efficacy of a standard therapeutic dose of tianeptine (12.5 mg t.i.d) in the treatment of major depressive episodes has been shown to be similar to that of amitriptyline 25 mg t.i.d., imipramine 25 mg t.i.d., mianserin 60 mg/day, and fluoxetine 20 mg/day with little evidence of accompanying somatic side-effects (Guelfi et al 1992). Tianeptine has also been shown to have significant antidepressant activity compared to placebo (Costa e Silva et al 1997), to be effective in the treatment of anxiety symptoms in depressed patients (Guelfi et al 1989;Ruschel et al 1994) and to reduce depression after alcohol withdrawal (Lôo et al 1988;Malka et al 1992). Elderly patients and those who are in alcohol withdrawal are known to have increased sensitivity to the adverse effects associated with psychotropic drugs (Wilde and Benfield 1995), but the pharmacological profile of tianeptine is consistent with its relative lack of sedative, anticholinergic and cardiovascular effects, which may make it suitable for use in a broad spectrum of hospitalised and ambulant patients.…”

Section: Introductionmentioning

confidence: 97%