Tianeptine toxicity: Difference between revisions
Fredvarone (talk | contribs) (Created page with "==Background== *Tianeptine is an atypical antidepressant that affects multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod * ==Clinical Fe...") |
Fredvarone (talk | contribs) |
||
| Line 29: | Line 29: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
# Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon. | |||
Revision as of 19:11, 4 August 2020
Background
- Tianeptine is an atypical antidepressant that affects multiple neurochemicals and receptors including serotonin, glutamate, NMDA, and μ-opiod
Clinical Features
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Toxidrome Chart
| Finding | Cholinergic | Anticholinergic | Sympathomimetic | Sympatholytic^ | Sedative/Hypnotic |
| Example | Organophosphates | TCAs | Cocaine | Clonidine | ETOH |
| Temp | Nl | Nl / ↑ | Nl / ↑ | Nl / ↓ | Nl / ↓ |
| RR | Variable | Nl / ↓ | Variable | Nl / ↓ | Nl / ↓ |
| HR | Variable | ↑ | ↑ (sig) | Nl / ↓ | Nl / ↓ |
| BP | ↑ | ↑ | ↑ | Nl / ↓ | Nl / ↓ |
| LOC | Nl / Lethargic | Nl, agitated, psychotic, comatose | Nl, agitated, psychotic | Nl, Lethargic, or Comatose | Nl, Lethargic, or Comatose |
| Pupils | Variable | Mydriatic | Mydriatic | Nl / Miotic | |
| Motor | Fasciculations, Flacid Paralysis | Nl | Nl / Agitated | Nl | |
| Skin | Sweating (sig) | Hot, dry | Sweating | Dry | |
| Lungs | Bronchospasm / rhinorrhea | Nl | Nl | Nl | |
| Bowel Sounds | Hyperactive (SLUDGE) | ↓ / Absent | Nl / ↓ | Nl / ↓ |
- ^Consider Sympatholytic when looking at Sedative OD or someone who doesn't respond to Narcan
- Withdrawal from substances have the opposite effect
Evaluation
Management
Disposition
See Also
External Links
References
- Zahran et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System – United States 2000-2017. MMWR Morb Mortal Wkly. Rep 2018;67:815-818. DOI: http://dx.doi.org/10.15585/mmwr.mm6730a2external icon.