Tianeptine Abuse and Dependence: Case Report and Literature Review

Lauhan, Rahul; Hsu, Alan; Alam, Al; Beizai, Kristin

doi:10.1016/j.psym.2018.07.006

Cited by 29 publications

(34 citation statements)

References 22 publications

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“…First, we confirm the existence of antidepressant abuse in subjects with OUD. This result corroborates previous case reports in several countries during the last decades, involving in particular amineptine, which was withdrawn since then [19]; tianeptine, which is structurally related to amineptine [20,21]; amitriptyline, which also has sedative and anticholinergic effects [22,23]; and more recently venlafaxine [24]. Since then, it has been shown that amitriptyline and mianserin have a dopaminergic effect [25], and that tianeptine and mianserin have an opioid effect [26,27].…”

Section: Main Findingssupporting

confidence: 90%

Antidepressants abuse in subjects with opioid use disorders: A 10‐year study in the French OPPIDUM program

Dumonceau

Soeiro

Lacroix

et al. 2021

Fundamemntal Clinical Pharma

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Accumulating evidence shows that some antidepressants are abused for their psychostimulant effects, but the extent of antidepressants abuse is unknown in subjects with opioid use disorders (OUD). The objective of this work is to assess the prevalence of antidepressant abuse and its correlates in subjects with OUD. Subjects ≥18 year-old in an opiate maintenance treatment (OMT) program who reported using an antidepressant were selected from the OPPIDUM program from 2011 to 2020. The outcome was antidepressant abuse. Antidepressant abusers were identified as subjects reporting at least one of the following behaviors: "drug abuse," "concomitant use of alcohol," "illegal obtaining," and "dose higher than recommended in the Summary of Product Characteristics." Among the 83 040 observations of subjects ≥18 year-old in an OMT program included in the OPPIDUM program from 2011 to 2020, 2708 (3.3%) subjects reported using an antidepressant in monotherapy. Among them, there were 385 (14.2%) abusers. The proportion of abusers was the highest for amitriptyline (n = 31, 25.0%). In multivariate analysis, antidepressant abuse was positively associated with amitriptyline (OR 2.07, 95% CI [1.16, 3.73]; p = 0.015), unemployment (OR 1.52, 95% CI [1.16, 2.01]; p = 0.003), the use of intravenous route of administration (OR 1.77, 95% CI [1.12, 2.80]; p = 0.014), and the use of benzodiazepines (OR 1.53, 95% CI [1.21, 1.94]; p < 0.001). Clinicians should be aware of the risk of antidepressant abuse when prescribing in subjects with OUD, accounting for their heterogeneous pharmacological properties that may account for their abuse potential.

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Section: Main Findingssupporting

confidence: 90%

Antidepressants abuse in subjects with opioid use disorders: A 10‐year study in the French OPPIDUM program

Dumonceau

Soeiro

Lacroix

et al. 2021

Fundamemntal Clinical Pharma

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“…Also, intensified anxiety was present before alcohol problems began. These elements make tianeptine dependence diagnosis doubtful and indicate rather a personality predisposition to substance misuse, than a special addictive mechanism of tianeptine itself, as suggested in other publications 5,6 .…”

mentioning

confidence: 91%

Excessive consumption of tianeptine by a person with former alcohol problem

Grabowski¹,

Bidzan²

2020

Arch Clin Psychiatry

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“…Despite not being approved for use in the United States, reports of serious adverse events involving tianeptine have increased significantly, from 11 cases in the years between 2000 and 2013 to 151 cases in the year 2020 alone (FDA, 2022). Nurses should be aware of serious or even fatal opiate-like intoxication or withdrawal symptoms that may present in the absence of positive urine drug screens or in cases where withdrawal does not follow expected patterns (Lauhan et al, 2018). The associated health effects of tianeptine exposure and misuse include neurologic, cardiovascular, and gastrointestinal symptoms, which manifest in a similar manner to opioid toxicity and opioid withdrawal syndromes (El Zahran et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Nursing Implications for Tianeptine Use and Misuse

Hargett,

Lowry,

Lee

2023

UJAN

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Tianeptine is an atypical antidepressant that is not approved for use in the United States and has a significant potential for abuse. In recent years, illicit use and misuse of tianeptine have become increasingly common. Symptoms caused by illicit use and withdrawal from tianeptine have become an emerging public health concern. Nurses should be aware of serious or even fatal opiate-like intoxication or withdrawal symptoms, which may present in the absence of a positive urine drug screen or in cases where withdrawal does not follow expected patterns. The associated health effects of tianeptine exposure and misuse include neurologic, cardiovascular, and gastrointestinal symptoms, which manifest in a similar manner to opioid toxicity and opioid withdrawal syndrome. People who illicitly use or misuse tianeptine should be educated regarding the risks associated with this drug. In addition, nurses should promote screening, intervention, and referral to treatment for this and other substance use disorders. Nurses should also support efforts to control access to products containing tianeptine.

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Tianeptine Abuse and Dependence: Case Report and Literature Review

Cited by 29 publications

References 22 publications

Antidepressants abuse in subjects with opioid use disorders: A 10‐year study in the French OPPIDUM program

Antidepressants abuse in subjects with opioid use disorders: A 10‐year study in the French OPPIDUM program

Excessive consumption of tianeptine by a person with former alcohol problem

Nursing Implications for Tianeptine Use and Misuse

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