Title: "Tianna Red" - Tianeptine, a new medication of abuse?<br/>Author: Hong Kim<br/><a href='http://umem.org/profiles/faculty/526/'>[Click to email author]</a><hr/><p>
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Tianeptine is an antidepressant with mu-opioid receptor agonism. It is available in several European countries for therapeutic use, but not available in the US.</p>
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There has been an increase in tianeptine exposure in the US since August 2019. Recently a retrospective observation study was done to characterize the clinical features associated with tianeptine exposure. </p>
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<strong>Result</strong></p>
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48 cases of tianeptine exposure were identified from January 1, 2015 to March 15, 2020 from a single poison center</li>
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37 cases (77%) occurred from May 2019 to March 2020.</li>
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Intoxication (n=11)</p>
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Withdrawal (n=27)</p>
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<strong>Symptoms </strong></p>
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· Lethargy: 7 (63%)</p>
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· Agitation: 3 (27%)</p>
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· Tachycardia: 3 (27%)</p>
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· GI distress: 2 (18%)</p>
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· Myoclonic/hallucination: 2 (18)</p>
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<strong>Symptoms</strong></p>
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· Anxiety: 12 (44%)</p>
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· GI distress: 3 (33%)</p>
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· Hypertension: 8 (30%)</p>
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· Agitation: 8 (30%)</p>
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· Tachycardia: 7 (26%)</p>
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<strong>Treatment</strong></p>
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· Naloxone: 3 (27%)</p>
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· Benzodiazepines: 2 (18%)</p>
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· Antipsychotics: 2 (18%)</p>
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· Antimuscarinic: 1 (9%)</p>
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<strong>Treatment</strong></p>
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· Benzodiazepine: 10 (37%)</p>
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· Opioids: 6 (22%)</p>
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· Alpha-2-agonist: 5 (19%)</p>
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· Antipsychotics: 5 (19%)</p>
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· Antimuscarinic: 5 (19%)</p>
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<strong>Disposition</strong></p>
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· ICU: 6 (55%)</p>
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· Non-ICU: 2 (18%)</p>
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· Discharged home: 2 (18%)</p>
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<strong>Disposition</strong></p>
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· ICU: 4 (15%)</p>
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· Non-ICU: 7 (26%)</p>
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· Psych: 1 (4%)</p>
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· Discharged home: 10 (37%)</p>
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<strong>Conclusion</strong></p>
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Tianeptine exposure is increasing in the US .</li>
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Intoxication frequently results in lethargy and/or agitation.</li>
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<fieldset><legend>References</legend>
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Rushton W et al. Characteristics of tianeptine effects reported to a poison control center: a growing threat to pubic health. Clin Toxicol (Phila) 2020. <span style="font-family: ArialUnicodeMS; font-size: 10pt; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);">DOI: 10.1080/15563650.2020.1781151</span></p>
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