Risk Management in Tianeptine Abuse in Turkey: A National Experience

Objective: Tianeptine is used in the treatment of major depressive episodes and has structural similarities with tricyclic antidepressants although it has different pharmacological properties and has abuse potential among patients with a history of dependence or abuse of any drug or alcohol. In this study, we aimed to evaluate the safety problems and risk management measures for tianeptine in Turkey in relation to its abuse potential. Methods: Adverse event reports noting tianeptine abuse and the risk management measures for use of this agent have been evaluated through retrospective examination of the databases of the Turkish Medicines and Medical Devices Agency, the Intercontinental Medical Statistics (IMS), the Uppsala Monitoring Centre (Vigiflow) and the Turkish Pharmaceuticals Track and Trace System. Results: After three individual fatal cases were reported in 2011 and 2012 associated with tianeptine abuse and increased tianeptine abuse reports were received by the risk management department, tianeptine has been included in the controlled substances list in Turkey since October 2012. Conclusion: Although tianeptine has several advantages compared with tricyclic antidepressants, it should be carefully observed for abuse potential especially in patients with the history of dependence or abuse of any drug or alcohol.