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Yıl:2006; Cilt: 17; Sayı: 1>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2006;17(1):72-75
Tiyaneptin Kötüye Kullanımı: Bir Olgu Sunumu
Ö Saatçioğlu, R Erim, D Çakmak
Bakırköy. Prof., Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul.
Tiyaneptin, serotonin geri alım engelleyicilerine (SSRI) benzer etki potansiyeline sahip, antidepresan bir ajandır. Anksiyolitik etki profili açısından trisiklik ve tetrasikliklere benzerlik göstermektedir. Kognitif yönden tiyaneptinin dikkati ve öğrenmeyi artırdığı belirtilmektedir. Tiyaneptinin aşırı miktarda alınması konusunda çok az vaka bildirilmiştir. Yüksek doz tiyaneptin kullanımı ile ilgili yapılan birçok çalışmanın sonuçlarına uymamakla birlikte tiyaneptin, kötüye kullanımı ile ilgili olgu sunumlarında özellikle uyarıcı etki vurgulanmıştır. Bazı olgu sunumlarında tiyaneptine tolerans geliştiği, güçlü hissetme hali olduğu ve yeniden alınmaması durumunda fiziksel yoksunluk işaretlerinin görüldüğü belirtilmiştir. Tiyaneptin tedavisi, yüksek doz kullanma ve tolerabilite yönünden bağımlı hastalarda risk oluşturabilmektedir. Bu makalede 24 yaşında geçmişte eroin, esrar ve kokain kullanmış olan, bir yıldan beri bu maddeleri kullanmayarak sadece artan dozda tiyaneptin almaya başlayan bir olgu sunulmuştur. Tiyaneptinin uyarıcı etkisinin olduğunu belirten ve bir yıl içerisinde tiyaneptin dozunu artırarak günde 3000 mg kullanmaya başlayan ve çoğul madde bağımlılığı bulunan hastada tiyaneptinin etkisi, kötüye kullanımı ve bağımlılık riski tartışılmıştır.

A Case of Tianeptine Abuse
Tianeptine is an antidepressant agent like the selective serotonin reuptake inhibitors (SSRIs). The anxiolytic efficacy of tianeptine is similar to that of tricyclic and tetracyclic antidepressants. Very few cases have been reported in connection with excessive consumption of tianeptine. Although it is not reconciled with results of many studies on excessive consumption of tianeptine, stimulant action has been specifically emphasized on some case reports of tianeptine abuse. These reports indicate that a tolerance is developed, there is a strong mode of feeling, and there are physical withdrawal symptoms if not taken again. Treatment with tianeptine can pose a risk for addicted patients in terms of high doses as well as tolerability. In this article, we report a 24- [year]-old patient who abused tianeptine for one [year]. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seeks a psychostimulant effect. The patient had a previous history of addiction to cannabis, opiates and cocaine. We concluded that the effect of tianeptine and its addiction risk at the patient who had a history of addiction to multiple substances, and spontaneously increased dose of tianeptine during the last one [year] up to 3000 mg per day at present. In the literature, reports of addictions to antidepressants are scarce and most of them involve agents with amphetamine-like properties, including amineptine and tranylcypromine. Other reports involving other antidepressant agents, including amitriptyline, fluoxetine and tianeptine remain exceptional.

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