Characteristics of tianeptine exposures reported to the NPDS

CDC analyzed data from the National Poison Data System (NPDS) for insight on U.S. exposures to tianeptine, an atypical tricyclic agent that lacks FDA approval but that Americans can still acquire over the internet.

CDC analyzed data from the National Poison Data System (NPDS) for insight on U.S. exposures to tianeptine, an atypical tricyclic agent that lacks FDA approval but that Americans can still acquire over the internet. Researchers counted 218 poison control center calls reported to NPDS regarding tianeptine exposure during 2000–17, slightly more than one-half of them involving tianeptine exclusively. Most episodes affected individuals aged 21–40 years and produced moderate neurological, cardiovascular, and gastrointestinal outcomes. While exposure activity was low for most years of the study, researchers noticed a surge in tianeptine-related calls starting in 2014—possibly due to study results demonstrating the drug as an effective mu- and delta-opioid receptor. However, the opioid-like effects and adverse events from tianeptine, which is used in other countries as an antidepressant, raised red flags about a latent public health risk. Indeed, case reports indicate tianeptine has the potential for user toxicity, likely treatable with naloxone; addiction and withdrawal; neonatal abstinence syndrome in babies born to tianeptine-dependent mothers; and even death. The CDC analysis underscore the need for public outreach to increase awareness of tianeptine and its risks, as well as greater surveillance and reporting within the medical community.