Effectiveness of tianeptine in patients with major depressive disorder and substance use disorder

Introduction. The depressive disorder coexists in a high prevalence with a substance-related disorder, which is associated with a worst prognosis. The therapeutic interventions for this co-morbidity lack of the appropriate scientific support. The existing evidence suggest that the currently available anti-depressive drugs are of minor efficacy in this group of patients. An alternative would be the use of different drugs with distinctive neurobiological mechanism of action. The aim of this study was to describe the clinical development of a series of patients affected by this comorbidity under treatment with tianeptine under usual clinical practices. Methods. Study design corresponds to a post-authorization, observational, retrospective, multicentric, study under usual clinical practice study. The clinical history of the last consecutive 100 patients diagnosed of major depressive and substance-related disorders under treatment with tianeptine for at least 3 months was reviewed. The following scales were evaluated in 3 times (basal, intermediate, final): HDRS, ICG and SDS. Results. Most patients were treated by a combination of anti-depressive drugs together with psychotherapy. At the end of follow-up, 70 % patients had a clinical remission in accordance with HDRS and 76 % of them had a mild or significant improvement in ICG. Regarding the use of substances, the most remarkable decreases were obtained in the consumption of alcohol, and cocaine. Conclusion. Tianeptine could be a useful drug for the treatment of patients with dual diagnosis of depression and substance-related disorder, together with other therapeutic interventions.