Article

Switching to tianeptine in patients with antidepressant-induced sexual dysfunction

Firat University, School of Medicine, Department of Psychiatry, Elazig, Turkey.
Human Psychopharmacology Clinical and Experimental (Impact Factor: 2.19). 06/2003; 18(4):277-80. DOI: 10.1002/hup.479
Source: PubMed

ABSTRACT

Sexual side effects are frequent and are recently being considered as effects of antidepressant treatment. One method to improve the sexual dysfunction associated with the use of antidepressants is to change to another antidepressant. In the present work, the consequences of switching to tianeptine in patients with antidepressant-induced sexual dysfunction were studied. The study group comprised 23 patients with major depressive disorder who experienced antidepressant-induced sexual dysfunction. These antidepressants were stopped and switched to tianeptine (12.5mg x 3/day). All patients were screened by using the clinical global impression-improvement scale (CGI-I), the Hamilton depression rating scale (HAM-D) and the Arizona sexual experience scale (ASEX) at the beginning of the study, and at weeks 4 and 8. No patient failed to tolerate 37.5mg of tianeptine or to complete the study except for one patient becoming pregnant. Paired t-tests revealed a significant difference between baseline and week 4 or week 8 in scores on both the HAM-D and ASEX. At 8 weeks, six patients were rated as very much improved (CGI-I=1) and ten patients were rated as much improved (CGI-I=2). Thus, with a CGI-I score of 2 or less used to indicate a positive response, 72.7% of the patients were responders. The results suggest that switching to tianeptine appears to be useful for alleviating sexual dysfunction caused by other antidepressants.

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    • "Tianeptine’s mechanism of action ostensibly defies logic as it enhances rather than inhibits reuptake of serotonin at the serotonin transporter site. Human studies show rapid relief of depressive symptoms (Novotny and Faltus, 2003) and good tolerability of tianeptine as compared to SSRIs (Atmaca et al., 2003; Bonierbale et al., 2003). One possible mechanism of action of tianeptine is that it blocks stress-induced glutamate transporter-1 mRNA (GLT-1 mRNA) expression and stress-induced decreases in hippocampal volume (Reagan et al., 2004). "
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    • "In summary, tianeptine is a well-described antidepressant with effective actions against stress-induced deficits of the nervous system. It is as effective as SSRIs in treating depression, produces fewer adverse side effects and reduces anxious symptoms associated with depression without the need for concomitant anxiolytic therapy [18,19,20,21,207]. It is therefore relevant to note that tianeptine has been shown to ameliorate symptoms in people with post-traumatic stress disorder (PTSD) [208] and in recent work has been shown to block the effects of intense stress on behavior and cardiovascular systems in an animal model of PTSD [100]. "
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    Full-text · Article · Oct 2010 · Pharmaceuticals
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    • "In summary, tianeptine is a well-described antidepressant with effective actions against stress-induced sequelae of the nervous system. It is as effective as SSRIs in treating depression, produces fewer adverse side effects and reduces anxious symptoms associated with depression without the need for concomitant anxiolytic therapy [5,16,19,61,188]. It is therefore relevant to note that tianeptine ameliorates symptoms in people with post-traumatic stress disorder (PTSD) [134] and in recent work has been shown to block the effects of intense stress on behavior and cardiovascular systems in an animal model of PTSD [212]. "
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