Tianeptine: Is safe use possible?

Tianeptine: Is safe use possible?

Tianeptine is a medicine available for use in some European, Asian and South American countries to treat anxiety, depression and irritable bowel syndrome. In other countries, including the U.S., tianeptine is not approved for any medical use.

Although tianeptine is not approved in the U.S., it can be bought online and at small stores. It may be sold under names such as ZaZa or Tianna Red. Tianeptine may be referred to as “gas station heroin.” In some places it is labeled as a dietary supplement that enhances cognition and stabilizes mood. Tianeptine also may be labeled to help with pain, decrease appetite and increase sexual performance.

When taken in small doses, tianeptine may help with symptoms of anxiety, depression and irritable bowel syndrome. However, misuse can lead to taking larger doses and dependence. When taken at higher doses, tianeptine can cause a high or a feeling of euphoria. Taking high doses of tianeptine can be fatal.

Some people take tianeptine with opioids, alcohol or other drugs to heighten the effects. Mixing these substances may lead to increased heart rate, lowered blood pressure, seizures and cardiac arrest. Tianeptine is sometimes misused to self-treat withdrawal symptoms from alcohol and other substances. People with a history of substance misuse are at a higher risk of misusing tianeptine.

Side effects and withdrawal symptoms

Tianeptine can have side effects, even when taken at lower doses. These may include:

  • Abdominal pain.
  • Bad dreams.
  • Constipation.
  • Dizziness.
  • Drowsiness.
  • Dry mouth.
  • Headache.
  • Nausea.

When people stop taking tianeptine they may have withdrawal symptoms right away. Symptoms of tianeptine withdrawal are similar to those of opioid withdrawal and may include:

  • Agitation.
  • Anxiety.
  • Chills and trembling.
  • Depression.
  • Muscle pain.
  • Sweating.

While tianeptine may help treat depression, anxiety and irritable bowel syndrome, the risks often outweigh the benefits. Tianeptine is usually sold as a dietary supplement that can help with energy, mood, pain, sexual performance and appetite control. However, tianeptine can have ill effects and can even lead to death. Talk to your healthcare professional if you have questions about care for depression, anxiety or other conditions.

March 29, 2024

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  2. Cohen P. High-risk dietary supplements: Patient evaluation and counseling. https://www.uptodate.com/contents/search. Accessed Feb. 5, 2024.
  3. Edinoff AN, et al. Tianeptine, an antidepressant with opioid agonist effects: Pharmacology and abuse potential, a narrative review. Pain and Therapy. 2023; doi:10.1007/s40122-023-00539-5.
  4. Tianeptine products linked to serious harm, overdoses, death. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/tianeptine-products-linked-serious-harm-overdoses-death. Accessed Feb. 8, 2024.
  5. Counts CJ, et al. Notes from the field: Cluster of severe illness from Neptune’s Fix tianeptine linked to synthetic cannabinoids — New Jersey, June–November 2023. MMWR Morbidity and Mortality Weekly Report. 2024; doi:10.15585/mmwr.mm7304a5.

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