Author: James Anderson

Tianeptine Products Linked to Serious Harm, Overdoses, Death

It binds to certain DNA sequences called cAMP response elements (CRE), thereby increasing or decreasing the transcription of the genes.58 CREB has a well-documented role in neuronal plasticity and long-term memory formation in the brain. “A lot of these commercial tianeptine products contain 100 times the normal therapeutic dose, and because it’s not regulated, people are unknowingly taking high doses that can lead to dangerous side effects,” Dr. Anand states. In the U.S., reports of severe side effects involving tianeptine are increasing. There are several published case reports of tianeptine intoxication and death 28. An overdose of tianeptine can lead to opiod-like effects and lead to respiratory failure and death, due to its direct effect on the mu opioid receptor 28.

Other names for tianeptine

Tianeptine is still available at gas stations and convenience stores in 41 other states and is purchasable online. It’s up to individuals to know the dangers and avoid purchasing any related products. In the U.S., emergency calls about tianeptine spiked after the opioid findings emerged.

Studies had suggested it can improve memory and ease anxiety and bring other benefits. This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. Addiction psychiatrist Akhil Anand, MD, explains the facts about this dangerous substance.

What are the side effects of tianeptine?

Tianeptine, also known as “gas station heroin,” is officially off the market—at least in Florida. A literature review conducted in 2018 found 25 articles involving 65 patients with tianeptine abuse or dependence.37 Limited data showed that a majority of patients were male and that age ranged from 19 to 67. Routes of intake included oral, intravenous, and insufflation entry. In the 15 cases of overdose, 8 combined ingestion with at least one other substance, of which 3 resulted in death. Six additional deaths are reported involving tianeptine (making it 9 in total).

Some of these poisonings occurred the first time people ingested the substance. Florida’s attorney general issued an emergency ban in September after an increasing number of calls to the state’s Poison Control Center in the first half of 2023. A similar trend has been seen nationwide with 151 tianeptine poisoning cases in 2020. There are also reports of at least five fatal overdoses since the drug started being sold in the US. The flood of stories about its habit-forming properties are another sign of tianeptine’s spread. In the Reddit forum about quitting the drug, people who describe themselves as former heavy users of opioids say tianeptine is as addictive, if not more, than other drugs they’ve used.

  1. Lack of a federal ban on tianeptine has meant states have been acting on their own.
  2. The metabolite profiles of tianeptine in feces and plasma were found to be qualitatively similar to that in urine 8.
  3. In the 15 cases of overdose, 8 combined ingestion with at least one other substance, of which 3 resulted in death.
  4. People quickly develop a tolerance to tianeptine which causes them to increase how much they take, which is a clear sign of addiction and dependence.
  5. The drug’s true identity emerged after researchers figured out it’s a type of opioid — one that does, in fact, work in a way that’s similar to heroin.
  6. It’s illegal to market or sell the drug, but it’s also not on the list of federally controlled substances.

What to do for an opioid overdose

In the U.S., reports of bad reactions and unwanted effects involving tianeptine are increasing. Poison control center cases involving tianeptine exposure have increased nationwide, from 11 total cases between 2000 and 2013 to 151 cases in 2020 alone. Although other countries have approved tianeptine to treat depression and anxiety, some have restricted how tianeptine is prescribed or dispensed, or revised the drug label to warn of possible addiction. Data indicate tianeptine may be similar to opioids in terms of addiction and withdrawal potential as well as withdrawal symptoms. Although the exact length of time it would take someone to become addicted to tianeptine is not yet known, case reports suggest it could take as little as a few weeks with regular use.

Tianeptine withdrawal has been documented since at least 2017, when Yale clinicians described “a significant withdrawal syndrome” in a 36-year-old patient who was trying to quit the drug. The man bought the drug online and had been self-medicating his depression. In 2007, Stablon added a warning that patients with a history of addiction should be closely monitored. They were excited to discover a unique antidepressant mechanism — but they were also well aware of surging opioid addiction in the U.S.

More on Vitamins & Supplements

Launched in Europe in the 1980s, tianeptine has never been cleared by the U.S. It’s sold in the U.S. as a nootropic, a substance promising to enhance users’ mood and cognitive function. The drug’s true identity emerged after researchers figured out it’s a type of opioid — one that does, in fact, work in a way that’s similar to heroin. People who abuse tianeptine report that it has left them wrestling with addiction. When taken in small doses, tianeptine may help with symptoms of anxiety, depression and irritable bowel syndrome.

The drug worked, but no one knew how

Providers in Europe can still legally prescribe tianeptine, but only as a controlled substance. Deaths from overdose of tianeptine have been reported in the U.S. and overseas. At high doses or in combination with other substances, tianeptine can be dangerous. Most overdoses require naloxone and/or high doses of sedatives to manage. Initial withdrawal symptoms usually last 5 to 7 days and admission to an intensive care unit is often needed because the symptoms are so bad.

The clinical effects of tianeptine abuse and withdrawal can mimic opioid toxicity and withdrawal, according to the Centers for Disease Control and Prevention (CDC). Tianeptine is a non-prescription antidepressant that has become a popular method of getting high in the US in the past decade. It’s even been found in powder form in counterfeit pills of hydrocodone and oxycodone. Some products market dietary supplements containing tianeptine under the brand names Tianaa, Tianna Green, Tianna Red, Tianna White, and ZaZa.

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. 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.

We have issued warning letters to companies illegally marketing tianeptine products as dietary supplements and unapproved drugs. We also have issued import alerts to help stop tianeptine shipments at our borders. Cases described in medical journals, in calls to U.S. poison control centers, and in reports to the FDA suggest that tianeptine has a potential for abuse. People with a history of opioid use disorder or dependence may be at particular risk of abusing tianeptine.