Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-04-30T14:04:52.908Z Has data issue: false hasContentIssue false

Efficacy and acceptability of tianeptine in the elderly: a review of clinical trials

Published online by Cambridge University Press:  16 April 2020

F Raffaitin*
Affiliation:
17, rue des Marronniers, 75016Paris, France
Get access

Summary

The acceptability and efficacy of tianeptine were evaluated in three open trials in a total of 549 elderly patients, 426 of whom were treated for 3 months and 188 for 1 year. The therapeutic effect was that expected from an effective antidepressant, with a marked response after treatment for one month. In the geriatric trial, where patients were primarily dysthymic, continuation of treatment after 6 months consolidated the improvement already observed. Tianeptine also had a favorable long-term effect in chronic refractory depression. Drop-outs due to side-effects were few (4.4%), despite the high risk population. All pre-treatment complaints improved on tianeptine. The high frequency of somatic complaints expressed before treatment confirmed the extent to which depression is somatised in the elderly. Concomitant physical disease present in 87% of patients did not restrict the use of tianeptine. The fact that tianeptine has a low incidence of anticholinergic effects and no affinity for either H1 or α1 receptors makes it a particularly easy drug to use in elderly subjects who are sensitive to the side-effects of psychotropic agents.

Type
Review Article
Copyright
Copyright © Elsevier, Paris 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altamura, ACPercudani, MGuercetti, GInvernizzi, G (1988) Efficacy and tolerability of fluoxetine in the elderly: a double-blind study vs amitriptyline.In: Clinical Studies of Fluoxetine in Depression (Silverstone, T ed). CNS Publishers, London, 103106Google ScholarPubMed
Aronow, WS (1990) Cardiac risk factors: still important in the elderly. Geriatrics 45, 1, 7180Google ScholarPubMed
Baldwin, RCJolley, DJ (1986) The prognosis of depression in old age. Br J Psychiatry 7, 574583CrossRefGoogle Scholar
Beaumont, G (1987) Diagnosis and treatment of depression in general practice (Bizière, KGarattini, SSimon, P eds). In: Diagnosis and Treatment of Depression. Quo Vadis? Symposium - Sanofi Group, May 11-12 1987, Montpellier France, 245251Google Scholar
Butler, RN (1985) Geriatric Psychiatry.In: Comprehensive Textbook of Psychiatry IV (Kaplan, HISadock, BJ eds). Vol 2, Williams & Wilkins, Baltimore, 19531959Google Scholar
Carlhant, DLe Garrec, JGuedes, YSalvadori, CMottier, DRiché, C (1990) Pharmaco-kinetics and bioavailability of tianeptine in the elderly. Drug Invest 2 (3), 167172CrossRefGoogle Scholar
Chapuy, PCuny, GDelomier, YGalley, PMichel, JPPareaud, MMarey, C (1991) La dépression du sujet âgé. Intérêt de la tianeptine chez 140 patients traités pendant un an. Presse Méd 37, 18441852Google Scholar
Davie, JWBlumenthal, MDRobinson-Hawkins, S (1991) A model of risk of falling for psychogeriatric patients. Arch Gen Psychiatry 38, 463467CrossRefGoogle Scholar
Davis, J (1985) Antidepressant drugs.In: Comprehensive Textbook of Psychiatry IV (Kaplan, HISadock, BJ eds). Vol 2, Williams & Wilkins, Baltimore, 15131537Google Scholar
Delalleau, BDulcire, CLe Moine, PKamoun, A (1988) Analysis of the side effects of tianeptine. Clin Neuropharmacol 11 (suppl 2), S83S89Google ScholarPubMed
Demotes-Mainard, FGalley, PManciet, GVincon, GSalvadori, C (1991) Pharmacokinetics of the antidepressant tianeptine at steady-state in the elderly. J Clin Pharmacol 31, 174178CrossRefGoogle ScholarPubMed
Derogatis, LRLipman, RSRickels, KUhlenhuth, EHCovi, L (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom investory. Behav Sci 19, 115CrossRefGoogle Scholar
Feighner, JPAden, GCFabre, LFRickels, KSmith, WT (1983) Comparison of alprazolam, imipramine and placebo in the treatment of depression. JAMA 249, 30573064CrossRefGoogle ScholarPubMed
Goldstein, SE (1979) Depression in the elderly. J Am Geriatr Soc 27, 3842CrossRefGoogle ScholarPubMed
Gottfries, CG (1981) Treatment of depression in the elderly. General clinical considerations. In: Recent Advances in the Treatment of Depression. Acta Psychiatr Scand 290, 401409Google ScholarPubMed
Greenblatt, DJSellers, EMShader, RI (1982) Drug disposition in old age. N Engl J Med 306, 10811088Google ScholarPubMed
Guelfi, JDDreyfus, JFPull, CB (1983) A check list for the assessment of somatic symptoms (CHESS). Principal component and cluster analysis. Proceedings of the VIIth World Congress of Psychiatry, Vienna, Abstracts, Ciba-Geigy, p 454Google Scholar
Guelfi, JDDulcire, CLe Moine, PTafani, A (1992) Clinical safety and efficacy of tianeptine in 1858 depressed patients treated in general practice. Neuropsychobiology 25, 140148CrossRefGoogle ScholarPubMed
Guy, W (1976) ECDEU Assessment Manual for Psychopharmacology, US Department of Health Education and Welfare, Washington DCGoogle Scholar
Halper, JPMann, JS (1988) Cardiovascular effects of antidepressant medications. Br J Psychiatry 153 (suppl 3), 8798CrossRefGoogle Scholar
Hamilton, M (1959) The assessment of anxiety states by rating. Br J Psychiatry 32, 5055Google ScholarPubMed
Juel-Nieisen, NBille, MFlygenring, JHelagason, T (1961) Frequency of depressive states within geographically delimited population groups. 3. Incidence (The Aarhus County Investigation). Acta Psvchiatr Scand (suppl 162), 6980Google Scholar
Kay, DWKBeamish, PRoth, M (1964) Old age mental disorders in Newcastle upon Tyne, Part 1: a study of prevalence. Br J Pychiatry 110, 146158CrossRefGoogle Scholar
Kukull, WAKoepsell, TDInni, TSBorson, SOkimoto, JRaskind, MAGale, JL (1986) Depression and physical illness among elderly general medical clinic patients. J Affect Dis 10, 153162CrossRefGoogle ScholarPubMed
Labrid, CMocaër, EKamoun, A (1992) Neurochemical and pharmacological properties of tianeptine, a novel antidepressant. Br J Psychiatry 160 (suppl 15), 5660CrossRefGoogle Scholar
Lehmann, HE (1985) Affective disorders: clinical features.In: Comprehensive Textbook of Psychiatry IV (Kaplan, HISadock, BJ eds). Vol 1, Williams & Wilkins, Baltimore, 786811Google Scholar
Lôo, HDeniker, P (1988) Position of tianeptine among antidepressive chemotherapies. Clin Neuropharmacol 11 (suppl 2), S97S102Google ScholarPubMed
Lôo, HGanry, HMarey, CBriole, GCastelnau, DCharbonnier, JFDachary, JMDanion, JMDarcourt, GCapdeville, CDufour, HSouche, AEscande, MFavre, JDFéline, AGuelfi, JDLéger, JMMalauzat, DLemoine, PMalka, ROlié, JPDe Praingy, MScharbach, HScotto, JCTignol, JKamoun, A (1990) Acceptabilité et effieacité thérapeutique de la tianeptine chez 510 patients traités un an. JAMA (French edn), special issue, 4453Google Scholar
Lôo, HGanry, HDufour, HGuelfi, JDMalka, ROlié, JPScharbach, HTignol, JMarey, CKamoun, A (1992a) Long-term use in 380 depressed patients. Br J Psychiatry 160 (suppl 15), 6165CrossRefGoogle Scholar
Lôo, HGanry, HMarey, CBriole, GCastelnau, DCharbonnier, JFDachary, JMDanion, JMDarcourt, GCapdeville, CDufour, HEscande, MFavre, JDFéline, ALéger, JMMalauzat, DLemoine, PMalka, ROlié, JPDe Praingy, MScharbach, HScotto, JCTignol, JKamoun, A (1992b) Results of tianeptine psychotrope monotherapy in depressed patients treated for one year. Eur J Psychiatry 6, 1, 2939Google Scholar
Loughlin, KRWhitmore, WF (1987) Managing prostate disorders in middle age and beyond. Geriatrics 42, 7, 4556Google ScholarPubMed
Malka, RLôo, HGanry, HSouche, AMarey, CKamoun, A (1992) Long-term administration of tianeptine in depressed patients after alcohol withdrawal. Br J Psychiatry 160 (suppl 15), 6671CrossRefGoogle Scholar
Mocaër, ERettori, MCKamoun, A (1988) Pharmacological antidepressive effects and tianeptine-induced 5-HT uptake increase. Clin Neuropharmacol 11 (suppl 2), S32S42Google ScholarPubMed
Montgomery, SAÅsberg, M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 34, 382389CrossRefGoogle Scholar
Murphy, E (1983) The prognosis of depression in old age. Br J Psychiatry 142, 111119CrossRefGoogle ScholarPubMed
Murphy, ESmith, RLindesay, JSlattery, J (1988) Increased mortality rates in late-life depression. Br J Psychiatry 152, 347353CrossRefGoogle ScholarPubMed
Neshkes, REGerner, RJarvik, LFMintz, JJoseph, JLinde, SAldrich, JCoholly, MERosenn, RHill, M (1985) Orthostatic effect of imipramine and doxepin in depressed geriatric outpatients. J Clin Psychopharmacol 5, 102106CrossRefGoogle ScholarPubMed
Pitt, BMP (1987) Depression in the elderly.In: Diagnosis and Treatment of Depression. Quo vadis? (Bizière, KGarattini, SSimon, P eds). Symposium - Sanofi Group, May 11-12 1987, Montpellier France, 219226Google Scholar
Sweer, LMartin, DCLadd, RAMiller, JKKarpf, M (1988) The medical evaluation of elderly patients with major depression. J Gerontol Med Sci 43, 5358CrossRefGoogle ScholarPubMed
Viet, RC (1982) Depression in the elderly: pharmacologic considerations in treatment. Am Geriatr Soc 30, 581586Google Scholar
Weyerer, S (1992) Prevalence, course and treatment of depression among residents in old age homes. Clin Neuropharmacol 11 (suppl 1), Part A, 283A284ACrossRefGoogle Scholar
Zung, WK (1965) A self-rating depression scale. Arch Gen Psychiatry 12, 6370CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.