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, cocaïne 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.