Amineptine

Amineptine (Maneon® (Italy), Survector® (Spain, Italy, Philippines) is an atypical tricyclic antidepressant that selectively inhibits the reuptake of dopamine and to a lesser extent norepinephrine, thus exerting a powerful and fast-acting antidepressant effect. more...

Introduced in France in 1978 by the pharmaceutical giant Servier and marketed under the trade name Survector®, amineptine soon gained a reputation for abuse due to its short-lived, but pleasant, stimulant effect experienced by some patients. (This is to be distinguished from its antidepressant effect, which appears in approximately 7 days after commencing treatment.) This led to the FDA suspending the marketing authorisation for Survector® in 1999 and France withdrew it from the market, however several developing countries continued to produce it up until 2005.

Currently amineptine is off-patent and very difficult to obtain. Rare cases of hepatotoxicity, some serious, have been reported, but these were thought to be due to a genetic predisposition.

Therapeutic indications

Approved

Amineptine was approved in France for severe clinical depression of endogenous origin in 1978.

Unapproved/Off-Label/Investigational

Parkinson's Disease, amotivational syndromes, ADHD (Attention Deficit/Hyperactivity Disorder)

Mechanism of action

• Inhibitor of the reuptake of noradrenalin and dopamine.
• Little anticholinergic or antihistaminic effects.

Side effects

Dermatological

Severe acne due to amineptine was first reported in 1988 by various authors—Grupper, Thioly-Bensoussan, Vexiau, Fiet, Puissant, Gourmel, Teillac, Levigne, to name a few—simultaneously in the same issue of Annales de Dermatologie et de Venereologie and in the 12 March 1988 of The Lancet. A year later, Dr Martin-Ortega and colleagues in Barcelona, Spain reported a case of "acneiform eruption" in a 54-year-old woman whose intake of amineptine was described as "excessive." One year after that, Vexiau and colleagues reported six women, one of whom never admitted to using amineptine, getting severe acne concentrated in the face, back and thorax, the severity of which varied with the dosage (one of the women never admitted to using amineptine). Most of them were treated unsuccessfully with isotretinoin (Accutane®) for about 18 months; two of the three that discontinued amineptine experienced a reduction in cutaneous symptoms, with the least affected patient going into remission.

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