title: Neonatal Abstinence Syndrome Following Tianeptine Dependence During Pregnancy.
abstract: Tianeptine, an atypical antidepressant, has been found to exhibit a potential for abuse. The use of therapeutic doses of tianeptine during pregnancy has never raised safety concerns. However, the impact of tianeptine abuse on the mother-child dyad has never been assessed. We report herein the case of a female patient who presented with dependence on tianeptine, with the use of >650 mg of the drug per day. She had 2 successive pregnancies with similar doses. The state of dependence remained unidentified throughout the first pregnancy, but just after delivery, her full-term newborn exhibited unexpected neonatal abstinence syndrome (NAS). The NAS was successfully treated with morphine, although both the mother's and newborn's urine drug screen was negative. The causality of tianeptine in inducing NAS was retrospectively assessed as "probable" by using a validated causality algorithm. During the second pregnancy, this patient sought addiction treatment and was admitted for residential detoxification treatment in her seventh month of pregnancy. Delivery occurred at full term with a low birth weight neonate. No further developmental insults or medical problems were subsequently identified in the 2 children. Maternal tianeptine dependence during pregnancy may induce a type of NAS that mimics opiate NAS. This finding appears to be consistent with a recent finding of the agonist action of tianeptine on the opiate μ-receptor.
authors.affiliation: Service d'Addictologie, camille.bence@chru-lille.fr.
authors.forename: Camille
authors.initials: C
authors.lastname: Bence
authors.affiliation: Service de prise en charge de la toxicomanie et de la dépendance, CH de Valenciennes, France;
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bonord
authors.affiliation: Service de Psychiatrie Périnatale, Service de Psychiatrie de l'Enfant et de l'Adolescent, CHRU de Caen, France;
authors.forename: Camille
authors.initials: C
authors.lastname: Rebillard
authors.affiliation: Centre Pluridisciplinaire de Diagnostic Prénatal, and.
authors.forename: Pascal
authors.initials: P
authors.lastname: Vaast
authors.affiliation: Service de Pédiatrie, Centre Hospitalier de Douai, France;
authors.forename: Charlotte
authors.initials: C
authors.lastname: Alexandre
authors.affiliation: Service de Psychiatrie Périnatale, CURE, Hôpital Fontan, CHRU de Lille, France; PSYCHIC team, SCA-Laboratory, CNRS UMR-9193, and.
authors.forename: Renaud
authors.initials: R
authors.lastname: Jardri
authors.affiliation: Service d'Addictologie, Département de Pharmacologie, INSERM U1171, Université de Lille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rolland
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009020:Morphine / Q000627:therapeutic use*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D013841:Thiazepines / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D000929:Antidepressive Agents, Tricyclic; D013841:Thiazepines; C050504:tianeptine; D009020:Morphine