Tianeptine and alcohol dependence

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Alcohol dependence is frequently comorbid with depression.
• Serotonergic antidepressants show potential in treating alcohol dependence.
• Tianeptine has previously shown promise in depressed alcohol-abusing patients.

Purpose of the Study:

• To evaluate the efficacy of tianeptine in maintaining alcohol abstinence in non-depressed alcohol-dependent patients.
• To assess tianeptine's effect on relapse rates and alcohol consumption.
• To determine if tianeptine has a specific action on alcohol dependence beyond its antidepressant effects.

Main Methods:

• A multicenter, double-blind, placebo-controlled study.
• Inclusion of 342 non-depressed patients with DSM-III-R diagnosed Psychoactive Substance Dependence (alcohol).
• Treatment with tianeptine (12.5 mg t.i.d) or placebo for 9 months, with abstinence as the primary efficacy criterion.

Main Results:

• No statistically significant difference was observed between the tianeptine and placebo groups regarding the maintenance of abstinence.
• Both intention-to-treat and per-protocol analyses showed no benefit of tianeptine over placebo.
• Secondary outcome measures also did not reveal significant differences between the groups.

Conclusions:

• Tianeptine is not effective in maintaining alcohol abstinence in non-depressed alcohol-dependent individuals.
• The findings do not support the use of serotoninergic antidepressants for alcohol abstinence maintenance in this population.
• Tianeptine's indication should be confined to treating depressive syndromes in alcoholic patients.