What medication can be used to reverse some effects of tianeptine?
Naloxone. Tianeptine is a full agonist of mu-opioid receptors. Therefore, naloxone has a theoretical and some real-world experience with reversal of tianeptine overdose.
Dempsey SK, Poklis JL, Sweat K, Cumpston K, Wolf CE. Acute Toxicity From Intravenous Use of the Tricyclic Antidepressant Tianeptine. J Anal Toxicol. 2017 Jul 1;41(6):547-550. doi: 10.1093/jat/bkx034. PMID: 28541419; PMCID: PMC6075028.; Ari M, Oktar S, Duru M. Amitriptyline and tianeptine poisoning treated by naloxone. Hum Exp Toxicol. 2010 Sep;29(9):793-5. doi: 10.1177/0960327110372403. Epub 2010 May 24. Erratum in: Hum Exp Toxicol. 2010 Sep;29(9):797. PMID: 20498036
Contributed by Samuel Cory, DO, , PGY-3 emergency medicine resident at St. Rita’s Medical Center