Very few cases have been reported in connection with excessive consumption of tianeptine. Tianeptine use can be a risk in terms of high doses especially for addicted patients.

A 28 year-old man administered after 5-years of medical prescription of the recommended dosage of 12.5 mg 2 times daily of oral tianeptine for an anxiety disorder. The patient spontaneously increased the dosage which after two months reached 120 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect for five-years but after his family realized that he was using 2 boxes of drug every day he was hospitalized for treatment.

Tianeptine is an antidepressant agent like the selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. The anxiolytic efficacy of tianeptine is similar to that of tricyclic and tetracyclic antidepressants. But in contrast to SSRIs and tricyclic agents, systemic administration of tianeptine modestly enhanced the mesolimbic release of dopamine (DA). It is told that abuse or dependence of tianeptine is an important issue in patients who have histories of alcohol or substance abuse. However, as in our case, the use of tianeptine in patients without a history of substance abuse might be also a risk for addiction.