Overview

Tianeptine is a chemical that has activity in the brain. It can also mimic some of the effects and side effects of opioids, leading to its nickname, “gas station heroin.” Although there is interest in taking tianeptine for various reasons, it is not approved for any use in the U.S., and its benefits are not well defined. It has also been associated with serious health problems, including dependence, withdrawal, and opioid overdose. Common side effects include agitation, confusion, drowsiness, high blood pressure, fast heartbeat, nausea, vomiting, and sweating. Before taking tianeptine, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is tianeptine used for?

Tianeptine is sometimes used for pain, depression, anxiety, and opioid use disorder. However, its benefits are not well defined, and it may cause serious side effects in some people.

Note: Tianeptine is not approved by the FDA for any use. The FDA also does not consider tianeptine to be a legal dietary ingredient in the U.S. Learn more about the legal status of tianeptine here.

How does tianeptine work (mechanism of action)?

Tianeptine is a chemical that is made in a lab. It may change the levels and effects of certain brain chemicals. It can also bind to opioid receptors. This means that tianeptine can mimic the effects of opioids. In some countries, low doses of tianeptine are prescribed for depression and anxiety. But the actual effects of tianeptine are not well understood, and it is not clear how well it works for either of these uses.

In the U.S., some people use tianeptine to self-treat certain conditions, including pain and opioid use disorder. Since tianeptine can act like an opioid, it may help reduce pain and may also help someone reduce their use of another opioid. But it carries many of the same risks as opioids, including dependence and withdrawal. Some people also develop tolerance to its effects, meaning that they need to keep increasing their dose to notice any benefits. Other serious side effects associated with tianeptine include opioid overdose and death. This has earned it the nickname of “gas station heroin.” See the Side Effects section to learn more.

How should I store tianeptine?

You should store tianeptine according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of tianeptine?

The most common side effects of tianeptine are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Agitation or confusion
• Drowsiness
• Fast heartbeat
• High blood pressure
• Nausea or vomiting
• Sweating

There may be other side effects of tianeptine that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of tianeptine?

While less common, the most serious side effects of tianeptine are described below, along with what to do if they happen.

Severe Allergic Reactions. Tianeptine may cause allergic reactions, which can be serious. Stop taking tianeptine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Dependence and Withdrawal Reactions.Tianeptine may cause physical dependence, which means your body relies on it. This risk may be higher in people who use high doses of tianeptine regularly for a while. If you stop tianeptine suddenly, it could lead to withdrawal symptoms, which may be life-threatening. If you have been using tianeptine regularly for a while, do not stop taking it without talking with your health care provider. Your health care provider may be able to help you stop tianeptine in a way that will reduce the risk of getting withdrawal reactions. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

• Unusual movements, responses, or expressions
• Seizures
• Sudden and severe mental or nervous system changes
• Seeing or hearing things that others do not see or hear, also called hallucinations
• An extreme increase in activity or talking
• Losing touch with reality

Tolerance and Reduced Effect.Some people who take tianeptine regularly may develop tolerance to its effects. In many cases, people who develop tolerance will need to increase their dose to continue to feel the desired effects. But increasing the dose also increases the risk of having serious side effects. If you have been taking tianeptine regularly and no longer get the same effects, speak with a health care provider. Your health care provider may be able to help you find a medicine that treats your symptoms without causing tolerance.

Opioid Overdose. Tianeptine can mimic some of the effects of opioids. Taking too much tianeptine can cause an opioid overdose, leading to slow or shallow breathing, coma, or even death. Get emergency help if you or someone you know has any of the following symptoms.

• Changes in the color of your skin, including bluish color to your lips and fingernails
• Confusion
• Shortness of breath
• Feeling dizzy, lightheaded, or fainting
• Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat
• Slow or shallow breathing
• Excessive sleepiness or trouble staying awake

Precautions

Who should not use tianeptine?

Allergies to Ingredients. People who are allergic to any of the following should not take tianeptine.

• Tianeptine
• Any of the ingredients in the specific product

Ask your health care provider if you are not sure what ingredients are in a tianeptine product.

What should I know about tianeptine before using it?

The FDA does not consider tianeptine to be a legal dietary ingredient, and some U.S. states have banned the sale of tianeptine. However, it may still be available for purchase in many places. These products are not regulated and have not been tested to confirm that they contain the ingredients stated on their labels.

Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.

Keep tianeptine out of the reach of children.

Tianeptine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how tianeptine affects you.

If you have been taking tianeptine on a regular basis, do not stop taking it suddenly without talking to your health care provider. Stopping too quickly may cause serious side effects. See the Side Effects section for more details.

What should I tell my health care provider before using tianeptine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if tianeptine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Alcohol use disorder
• Substance use disorder, including cocaine, methamphetamine, or opioid use disorder
• Mental health problems, such as depression, anxiety, or suicidal thoughts
• Lung or breathing problems
• Heart problems
• High blood pressure
• Upcoming surgery or medical procedure

Other Medicines and Supplements.Tianeptine may interact with other medicines and supplements. Before taking tianeptine, tell your health care provider about any prescription or OTC medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Tianeptine may cause harm to a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if tianeptine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does tianeptine interact with foods or drinks?

There are no known interactions between tianeptine and foods or drinks.

Alcohol can increase the risk of confusion, drowsiness, and breathing problems when combined with tianeptine. This combination should be avoided.

Does tianeptine interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking tianeptine.

• Any medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety
• A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraine, or seizures
• A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
• A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, metaxalone, or tizanidine (Zanaflex)
• An opioid, such as codeine, fentanyl, morphine, oxycodone, or tramadol, which is a medicine used to treat certain types of pain
• A nonprescription opioid, such as heroin or kratom
• A street drug, such as cocaine or methamphetamine

The interactions between tianeptine and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with tianeptine is incomplete. Always check with your health care provider before taking tianeptine with any medicines.

Dosing

What should I do if I accidentally use too much tianeptine?

If you or someone else has used too much tianeptine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Some people have had physical dependence while using tianeptine, which means their bodies come to rely on it. Stopping tianeptine suddenly can lead to withdrawal. In the U.S., tianeptine is not a legal dietary ingredient and is known to cause serious side effects. It is best to avoid the use of tianeptine entirely.