Fatal intoxication with tianeptine (Stablon)

Area of Science:

• Forensic Toxicology
• Pharmacology

Background:

• Tianeptine, a serotonin reuptake enhancer structurally similar to tricyclic antidepressants, is prescribed for depression.
• Limited data exists on the post-mortem distribution and toxicological significance of tianeptine.

Observation:

• A fatal case involving a 26-year-old male found deceased with signs of tianeptine (Stablon) ingestion.
• Evidence included empty Stablon packaging, a suicide note, and frothy oral discharge.
• Post-mortem toxicological analysis was conducted using liquid-liquid extraction and LC-DAD-MS.

Findings:

• Detected tianeptine concentrations: blood 5.1 µg/mL, urine 2.0 µg/mL, liver 23 µg/g, stomach contents 22 mg.
• Ethanol concentration in femoral blood was 0.53 g/L.
• The developed LC-DAD-MS method demonstrated a detection limit of 0.001 µg/mL.

Implications:

• This study validates a method for tianeptine detection in post-mortem samples.
• Confirms tianeptine intoxication, in combination with ethanol, as a cause of death.
• Highlights the importance of comprehensive toxicological screening in suspected overdose cases.