CDC: Tianeptine Could Be An Emerging Public Health Risk

CDC has reported that misuse of tianeptine, a tricyclic antidepressant approved for use in Europe but not in the United States, increased in the US from 2014 to 2017, potentially due to the revelation that the drug is also an opioid receptor agonist.

Using data from the US National Poison Data System, the CDC identified 218 calls related to tianeptine exposure during 2000-2017, with tianeptine-only exposures, excluding 29 withdrawal-associated calls, accounting for 114 (52.3% of the calls. Eleven of these calls occurred during 2000-2013, while a significant increase in calls related to exposure and intentional abuse or misuse were received during 2014-2017, rising from 5 calls in 2014 to 38 calls in 2015, 83 in 2016, and 81 in 2017.

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The most commonly reported clinical effects among the 114 tianeptine-only exposures were neurologic (48.3%), cardiovascular (32.5%) and gastrointestinal (10.5%). Common therapies included fluids (35.1%), benzodiazepines (27.2%), and oxygen (10.5%). Among the withdrawal-associated calls, the most common symptoms were agitation (33.3%), nausea (33.3%), vomiting (19%), tachycardia (19.1%), hypertension (14.3%), diarrhea (9.5%), tremor (9.5%), and diaphoresis (9.5%). The most commonly administered therapies included benzodiazepines (57.1%), fluids (38.1%), and antiemetics (19.1%).

“The associated outcomes and health effects associated with tianeptine use suggest a possible emerging public health risk and underscore the need for public outreach to increase awareness. Tianeptine testing is not routinely available, but specialty-testing laboratories might have that capacity. Health care providers and public health officials need to be vigilant for potential cases of tianeptine exposure and, when applicable, report adverse effects to the FDA MedWatch reporting system,” the CDC concluded.

—Michael Potts

Reference:

Characteristics of tianeptine exposures reported to the National Poison Data System — United States, 2000–2017. MMWR Weekly. 67(30);815–818