Long Term Efficacy and Clinical Safety of Tianeptine in Depressed Alcoholic Patients after Alcohol Withdrawal

Abstract

A multicentre study was designed to treat patients presenting with a major depressive episode, single or recurrent, or dysthymic disorder with tianeptine for I year. 22% of these patients had a concurrent diagnosis of alcoholism. This intermediate analysis presents results obtained with the first 122 depressed alcoholic patients included, of which 63 were treated for I year. The results allow the evaluation of the long term efficacy and tolerability of tianeptine.The antidepressant activity of tianeptine was confirmed by an almost 50% reduction of initial Montgomery-Asberg depression rating scale scores after I month of treatment. Total scores and subscores of the Hamilton anxiety rating scale and Hopkins symptom checklist self-ratings Improved concomitantly. Single item and factor scores of the checklist for assessment of somatic symptoms indicated improvement in complaints present at the beginning of the study and an absence of notable adverse effects, particularly of the anticholinergic type. Three patients took massive doses of tianeptine; despite the association with alcohol, these patients did not show marked adverse effects.These results indicate the potential of tianeptine as an antidepressant in alcoholic patients after withdrawal of alcohol, its long term efficacy, and its good tolerability in patients who are particularly susceptible to the adverse effects of psychotropic drugs. The drug does not provoke orthostatic hypotension or weight change.