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

A total of 24 patients (male volunteers), consumers of opiates in the past and suffering from Tianeptine abuse, were under clinical observation. The age range of patients was from 21 to 33 years. Tianeptine consumption history was 5 months duration on the average. The daily dose of preparation was 40 tablets (500 mg intravenous injections on the average). Patients used Tianeptine in combination with antihistamines (Promethazine, Suprastin). Research was carried out with the use of clinical, psychological and laboratory methods. Has been used Ch. Spilberger's scale of anxiety and T. Balashov's scale of depression. Comparison of withdrawal syndrome developed after cessation of Tianeptine and opiates consumption has shown that in case of Tianeptine, in the dynamic of withdrawal syndrome predominates well expressed high-level of anxiety and depression, while at opiates consumption - withdrawal syndrome is characterized by algesic events and vegetodysfunctions. Supposedly, Tianeptine, in contrast to other anti-depressants, stimulates release of neurotransmitter dopamine in nucleus Accumbens, that probably determine addictive potential of this drug. High level of anxiety, excitability and vegetodysfunctions, presumably could be explained by activation of the NMDA (glutamate receptors) receptor system in Locus coeruleus, and in vegetative ganglion. In the present article potential threat that may develop at Tianeptine consumption, especially in former opiate consumers, without medic

Tianeptine is a dibenzothiazepine type an atypical, tricyclic antidepressant. Biochemically it has been shown that after single or repeated administration, tianeptine increases the presinaptic reuptake of serotonine at the brain and trombocytes. Tianeptine reduces the hypothalamic-pituitary-adrenal response to stress and antogonizes the behavoiral problems induced by stress. Its pharmacotherapotic effects are neither stimulant nor sedative. Addiction to antidepressant therapy is controversial and rarely defined at the literature. Here we represent the tolerance, withdrawal symptoms and treatment issues of the case whom misused tianeptine at extremly high doses. (Anatolian Journal of Psychiatry 2010; 11:190-193)

Madde kullanım bozukluğu olan gençler genellikle esrar, ekstazi, amfetamin türevleri, eroin, sedative hipnotikler gibi maddelere bağımlılık geliştirmektedirler. Bununla birlikte medikal hastalıklarda ve psikiyatrik bozuklarda kullanılan bazı reçeteli ilaçların kötüye kullanımı da bildirilmiştir. Özellikle modafinil, venlafaksin, ketiapin, tianeptin, gabapentin ve pregabalin son zamanlarda öne çıkmaktadır. Bir antiepileptik olan pregabalin anksiyete bozukluklarında da kullanılmaktadır. Anksiyolitik ve öforizan etkisi bu ilaca bağımlılık gelişmesinde önemli etkenlerdir. Literatürde pregabalin kötüye kullanımı ile ilgili bir çok olgu sunumu mevcut olup ergen olguya rastlanmamıştır. Bu yazıda opiat kullanım bozukluğu tanısı ile izlenen, ilk esrar kullanımı sonrasında panik atak belirtileri yaşayan ve bu belirtilerle baş etmek için kullandığı pregabalinin yatıştırıcı ve öforizan etkileri nedeniyle bu ilaca bağımlılık geliştiren ergen olgunun sunulması amaçlanmıştır.Madde kullanım bozukluğu olan gençler genellikle esrar, ekstazi, amfetamintürevleri, eroin, sedative hipnotikler gibi maddelere bağımlılıkgeliştirmektedirler. Bununla birliktemedikal hastalıklarda ve psikiyatrik bozuklarda kullanılan bazı reçeteliilaçların kötüye kullanımı da bildirilmiştir. Özellikle modafinil, venlafaksin,ketiapin, tianeptin, gabapentin ve pregabalin son zamanlarda öne çıkmaktadır.Bir antiepileptik olan pregabalin anksiyete bozukluklarında dakullanılmaktadır. Anksiyolitik ve öforizan etkisi bu ilaca b

Among adults who have used tianeptine, we aimed to determine demographic and substance-use patterns and gain insights into tianeptine doses, effects, and consumer conceptualizations. We also evaluated problematic use, quit attempts, and tianeptine-specific substance-use disorder (SUD). Between December 2023 and July 2024, an online survey was conducted. Participants were ≥18 years old and endorsed lifetime use of kratom, kava, tianeptine, and/or akuamma seed. Of the 369 respondents, 6.0% (n = 22) reported lifetime tianeptine use; they were 35.6 years old on average, White, and male (81.8%) and evinced diverse substance use. Mean age of tianeptine-use initiation age was 31.0. More within the tianeptine-use group believed they currently had any SUD (40.9% versus 20.2%, p = .0002), had ever been prescribed methadone/buprenorphine (27.3% versus 8.1%, p = .009), and were interested in recovery (72.7% versus 28.8%, p < .0001). Use motivations included euphoria, self-management of psychiatric symptoms, and drug substitution. Tianeptine-tolerance onset was considered rapid (59.1%), with one-third experiencing adverse effects. For past-year tianeptine SUD (n = 15), 13.3% of participants were mild, 53.3% were severe. Many tianeptine conceptualizations were unfavorable: "habit-forming" (68.2%), "addictive" (68.2%), "problematic" (59.1%); 86.3% believed overdose was possible. Tianeptine was used at low rates in this sample of adults who consumed gray-market supplements and included unfav