Use of Buprenorphine-Naloxone in the Treatment of Tianeptine Use Disorder

摘要

Tianeptine is an atypical antidepressant which exerts an opioid-like effect on the mu-opioid receptor. There is well documented intentional misuse and addiction to tianeptine in Europe, and this is increasingly being seen in the United States. We presented a case of buprenorphine/naloxone successfully being used to aid in cessation and subsequent abstinence from tianeptine after years of use. An additional consideration with tianeptine use is the potential for the development or re-emergence of depression and anxiety on cessation. Chronic daily use of tianeptine may represent tianeptine use disorder, which can have a clinical course consistent with opioid use disorder, including the development of impaired control, functional impairment, tolerance, and withdrawal. It is appropriate to consider medications for opioid use disorder for the management of tianeptine use disorder.