Tianeptine toxicity - Revision history

Rossdonaldson1: Text replacement - "opiod" to "opioid"

2023-10-18T17:34:33Z

Text replacement - "opiod" to "opioid"

← Older revision		Revision as of 17:34, 18 October 2023
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	==Background==		==Background==
	*Tianeptine is an atypical antidepressant that has different effects on multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and opioid		*Tianeptine is an atypical antidepressant that has different effects on multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and opioid
	* Full μ-~~opiod~~ receptor agonism can lead to effects similar to [[opioid]] toxicity and overdose		* Full μ-opioid receptor agonism can lead to effects similar to [[opioid]] toxicity and overdose
	*From 2014-2017 the USA saw a large increase in reported cases of [[tianeptine toxicity]] thought to be due to the discovery of its opioid effects and its ability to induce euophoria; it can be purchased online as a dietary supplement or research chemical<ref>Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.</ref><ref>Bakota EL et al. Case Reports of Fatalities Involving Tianeptine in the United States. Journal of Analytical Toxicology. 2018 Sep;42(7):503-509. DOI: 10.1093/jat/bky023.</ref>		*From 2014-2017 the USA saw a large increase in reported cases of [[tianeptine toxicity]] thought to be due to the discovery of its opioid effects and its ability to induce euophoria; it can be purchased online as a dietary supplement or research chemical<ref>Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.</ref><ref>Bakota EL et al. Case Reports of Fatalities Involving Tianeptine in the United States. Journal of Analytical Toxicology. 2018 Sep;42(7):503-509. DOI: 10.1093/jat/bky023.</ref>
	*Not FDA approved in the USA, still used in other countries as a treatment for depression		*Not FDA approved in the USA, still used in other countries as a treatment for depression

Rossdonaldson1: /* References */

2022-08-31T18:07:51Z

References

← Older revision		Revision as of 18:07, 31 August 2022
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	==References==		==References==
	<references/>		<references/>

			[[Category:Toxicology]]

Fredvarone: /* Background */

2020-08-05T17:40:21Z

Background

← Older revision		Revision as of 17:40, 5 August 2020
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	* Full μ-opiod receptor agonism can lead to effects similar to [[opioid]] toxicity and overdose		* Full μ-opiod receptor agonism can lead to effects similar to [[opioid]] toxicity and overdose
	*From 2014-2017 the USA saw a large increase in reported cases of [[tianeptine toxicity]] thought to be due to the discovery of its opioid effects and its ability to induce euophoria; it can be purchased online as a dietary supplement or research chemical<ref>Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.</ref><ref>Bakota EL et al. Case Reports of Fatalities Involving Tianeptine in the United States. Journal of Analytical Toxicology. 2018 Sep;42(7):503-509. DOI: 10.1093/jat/bky023.</ref>		*From 2014-2017 the USA saw a large increase in reported cases of [[tianeptine toxicity]] thought to be due to the discovery of its opioid effects and its ability to induce euophoria; it can be purchased online as a dietary supplement or research chemical<ref>Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.</ref><ref>Bakota EL et al. Case Reports of Fatalities Involving Tianeptine in the United States. Journal of Analytical Toxicology. 2018 Sep;42(7):503-509. DOI: 10.1093/jat/bky023.</ref>
			*Not FDA approved in the USA, still used in other countries as a treatment for depression

	==Clinical Features==		==Clinical Features==

Fredvarone at 19:40, 4 August 2020

2020-08-04T19:40:26Z

← Older revision		Revision as of 19:40, 4 August 2020
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	==Background==		==Background==
	*Tianeptine is an atypical antidepressant that ~~affects~~ multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod		*Tianeptine is an atypical antidepressant that has different effects on multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and opioid
	*		* Full μ-opiod receptor agonism can lead to effects similar to [[opioid]] toxicity and overdose
			*From 2014-2017 the USA saw a large increase in reported cases of [[tianeptine toxicity]] thought to be due to the discovery of its opioid effects and its ability to induce euophoria; it can be purchased online as a dietary supplement or research chemical<ref>Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.</ref><ref>Bakota EL et al. Case Reports of Fatalities Involving Tianeptine in the United States. Journal of Analytical Toxicology. 2018 Sep;42(7):503-509. DOI: 10.1093/jat/bky023.</ref>


	==Clinical Features==		==Clinical Features==
			*May share features of different toxicologic syndromes due to multiple receptors/neurotransmitters affected including [[opioid overdose]] and [[serotonin syndrome]]
			*[[AMS]]
			*[[Agitation]]
			*[[Coma]]
			*Respiratory depression
			*Diaphoresis
			*[[Nausea]]
			*[[Vomiting]]
			*[[Diarrhea]]
			*[[Tachycardia]]
			*[[Hypertension]]
			*Mydriasis or miosis

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*		*Mainly a clinical diagnosis
			*Assess airway first to determine need for [[intubation]]
			*POC glucose
			*EKG - look for widened QRS, [[prolonged QTc]]
			*Basic labs
			*Urine tox screen


	==Management==		==Management==
	*		*Airway management
			**[[Intubation]] if necessary
			*Oxygen for hypoxia
			*[[Naloxone]] has been successfully used to treat at least one case in the literature but data is limited<ref>Ari M, Oktar S, Duru M. Amitriptyline and tianeptine poisoning treated by naloxone. Hum Exp Toxicol. 2010;29(9):793-795. doi:10.1177/0960327110372403</ref>
			*[[Benzodiazepines]] for agitation

	==Disposition==		==Disposition==
			*Depends on severity of toxicity
			**Admit to floor vs ICU

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>
	# Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.

Fredvarone: /* References */

2020-08-04T19:11:52Z

References

← Older revision		Revision as of 19:11, 4 August 2020
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	==References==		==References==
	<references/>		<references/>
			# Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.

Fredvarone: Created page with "==Background== Tianeptine is an atypical antidepressant that affects multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod ==Clinical Fe..."

2020-08-04T16:54:09Z

Created page with "==Background== *Tianeptine is an atypical antidepressant that affects multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod * ==Clinical Fe..."

New page

==Background==
*Tianeptine is an atypical antidepressant that affects multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod
*

==Clinical Features==

==Differential Diagnosis==

{{Sedatve/hypnotic toxicity types}}

{{Template:Toxidrome Chart}}

==Evaluation==
*

==Management==
*

==Disposition==

==See Also==

==External Links==

==References==
<references/>