Posted by ed_uk on December 13, 2004, at 8:31:12
In reply to Re: servier, posted by sabre on December 13, 2004, at 1:09:30
Some info about tianeptine...
.......In Singapore the National Pharmaceutical Administration in the Ministry of
Health has restricted the use of tianeptine sodium to psychiatrists due to its abuse potential.....
[Misuse of tianeptine: five cases of abuse][Article in French]
Leterme L, Singlan YS, Auclair V, Le Boisselier R, Frimas V.
Service du Controle Medical, CPAM de Quimper, Cite du Guerlach, BP 1723, 29107 Quimper Cedex.
Five cases of excessive consumption of tianeptine suggest possible drug-abuse of this substance. This side effect is unknown in animals and humans. According to DSM IV, CIM 10 criteria and the French public health code, these five patients had pathological profiles of psychoactive drug abusers. Tianeptine dosage was always used higher than recommended and the drug was taken in association with other psychotropes. Withdrawal was difficult and induced anxiety and other disorders which led to relapse in most of the patients.
[Does addiction to antidepressants exist? About a case of one addiction to tianeptine][Article in French]
Guillem E, Lepine JP.
Espace Murger, Centre de Soins Specialise aux Toxicomanes, Service de Psychiatrie, Hopital Fernand-Widal (AP-HP), 200, rue du faubourg Saint-Denis, 75010 Paris.
We report on a tianeptine dependence lasting for eighteen months in a 42 year old patient. The patient had a previous history of addiction to opiates, amineptine, cocaine and alcohol. He also had a family history of addiction to alcohol and opiates. Tianeptine was prescribed for a major depressive disorder. The patient alleged a "flash sensation" like with heroin since the very first doses with a physical and psychological well-being sensation, better psychomotor performances and transient mood elation. His addiction to tianeptine was immediate and heavy. The positive reinforcement faded away after one month and a total dependance took over, with physical and psychological withdrawal symptoms when doses were not renewed. After two months of treatment, the daily consumption of tianeptine was of 90 tablets. The patient was hospitalised to treat both the addiction to tianeptine and the ongoing major depressive disorder. He was taking 240 tablets daily. In the literature, reports of addictions to antidepressants are scarce and most of them involve agents with amphetamine-like properties, including amineptine and tranylcypromine. Other reports involving other antidepressant agents, including amitriptyline, fluoxetine and tianeptine remain exceptional. Addictions to antidepressants almost exclusively concern patients with a diagnosis of personality disorder and a previous history of drug or alcohol abuse and who are treated for a depressive disorder. Tianeptine, which is devoid of any psychostimulating effect in human, does not seem to have addictive properties apart from the reports of scarce cases.
Encephale. 1999 Nov-Dec;25(6):672-3. Related Articles, Links
[Abuse of tianeptine. A case report][Article in French]
Vandel P, Regina W, Bonin B, Sechter D, Bizouard P.
Service de Psychiatrie et Psychologie Medicale, CHU Saint-Jacques, Besancon.
The authors report a case of tianeptine abuse in a 30 year-old woman. After a medical prescription of the recommended dosage of 12.5 mg 3 times daily of oral tianeptine for a depressive illness, the patient spontaneously increased the dosage which after two months reached 150 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect. After seven months of such a therapy, she was hospitalized to undergo a withdrawal. The discontinuation of the tianeptine treatment occurs in four days. A withdrawal syndrome marked by myalgia, and cold feeling was transient, and alleviated by sedative phenothiazine (cyamemazine) and myorelaxant benzodiazepine (tetrazepam).
Pharmacol Biochem Behav. 1999 Jun;63(2):285-90. Related Articles, Links
Although chemically related to amineptine, the antidepressant tianeptine is not a dopamine uptake inhibitor.Vaugeois JM, Corera AT, Deslandes A, Costentin J.
Unite de Neuropsychopharmacologie Experimentale, UPRES-A 6036 CNRS, IFRMP, UFR de Medecine et Pharmacie de Rouen, Saint Etienne du Rouvray, France.
We investigated whether the antidepressant tianeptine shares the dopamine uptake inhibitory properties of the chemically related antidepressant amineptine. Tianeptine dose dependently (5, 10, 20, 40 mg/kg IP) increased locomotor activity in mice. This stimulant effect (20 mg/kg IP) was dose dependently prevented not only by the D1 dopamine receptor antagonist SCH 23390 (7.5. 15, 30 microg/kg SC), but also by the D2 dopamine receptor antagonist haloperidol (50, 100, 200 microg/kg IP), in contrast to that elicited by dopamine uptake inhibitors. Where the latter prevent dexamphetamine-induced (3 mg/kg SC) reversion of akinesia in mice pretreated with reserpine (4 mg/kg SC, 5 h before test), tianeptine (20 mg/kg IP, 30 min before test) did not. Tested up to a concentration of 10-4 M, tianeptine did neither inhibit the [3H]dopamine uptake into mouse striatal synaptosomes nor compete in vitro with the specific binding of [3H]WIN 35,428 at dopamine transporters from striatal membranes. Finally, in mice injected IV with a tracer dose of [3H]WIN 35,428 (1 microCi), the highest tested dose of tianeptine (40 mg/kg IP) did not reduce the specific binding of the radioligand to striatal dopamine transporters. It is concluded that the antidepressant effect of tianeptine does not depend upon a blockade of the neuronal dopamine transporter.
Ed.
poster:ed_uk
thread:427416
URL: http://www.dr-bob.org/babble/20041211/msgs/428805.html