Does addiction to antidepressants exist?
About a case of one addiction to tianeptine

by
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.
Encephale. 2003 Sep-Oct;29(5):456-9.


ABSTRACT

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.
Heroin
Opiates
Alcohol
Amineptine
Metabolism
750mg/day
High-dosage
Long-term use
Psychostimulant?
Tianeptine (Stablon)
Tianeptine: structure
Melancholic depression
Tranylcypromine (Parnate)


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