What to know about tianeptine

Find out about tianeptine, a substance often found in energy shots & supplements, its dangers, side effects, and the importance of regulation in the US market.

Ophelia team
Tianeptine "Gas Station Heroin" bottles
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Fact checked by
Dana Drew, NP

If you’ve ever stopped at a gas station or convenience store during a long drive or a busy day of errands, you’ve probably looked at the tiny energy shots by the register—or even bought some—without thinking too much about the ingredients. While many of these products contain caffeine and other nutrients associated with energy, a substance called tianeptine is becoming more prevalent.

Tianeptine is a tricyclic medication that's prescribed as an antidepressant in Latin America, Asia, and Europe. However, the United States Food and Drug Administration (FDA) has not approved it for medical use. Nonetheless, the drug has found its way into the U.S. market, often in dietary supplements and energy shots.

Unfortunately, tianeptine can be extremely harmful, even leading to death. As an atypical antidepressant, the drug mimics opioids in the brain and can have dangerous side effects as well as addictive properties.

Before you reach for a supplement or energy shot, it’s important to understand what tianeptine is and why it’s dangerous for it to be sold in the U.S. without regulations. Greater awareness about the substance and its potential for addiction is an important step to keeping consumers safe.

What is tianeptine?

Commonly marketed as Stablon® or Coaxil®, tianeptine is prescribed in Asia, Latin America, and Europe, typically to treat major depressive disorders (MDD). In some instances, it has also been prescribed for the treatment of anxiety and irritable bowel syndrome.

The drug was initially developed as an antidepressant, with the aim of increasing serotonin uptake in the brain. However, it’s different from most other antidepressants, which work by increasing serotonin in the brain. Instead, tianeptine influences the glutamate and opioid receptors. This can result in an opiate-like effect, including feelings of euphoria.

Other possible side effects of tianeptine use include:

  • Abdominal pain
  • Nausea
  • Constipation
  • Headache
  • Light-headedness

When combined with other substances, like alcohol, benzodiazepines, or phenibut—a central nervous system depressant available in Russia and parts of Eastern Europe—tianeptine can cause difficulty breathing, drowsiness, confusion, coma, and even death.

Gas station heroin: What to know about tianeptine in the U.S. market

Although tianeptine, also referred to as tianeptine sulfate or tianeptine sodium powder, is not approved by the FDA for human consumption in the U.S., it's still sold illegally. It can be obtained in tablet or powder form, or as part of liquid products, like energy shots or drinks that claim to improve concentration.

People in the U.S. may get tianeptine online or at gas stations, smoke shops, or mini marts. The drug may be sold under various brand names, including "Tianna," "Tianna Green," "Tianna Red," "Tianna White," or "ZaZa." In some cases, tianeptine is included in unregulated dietary supplements, marketed under brand names like Neptune's Fix. Pegasus is another common name that consumers may recognize.

Due to the potential opioid-like effects, the possibility of addiction, and the availability at gas stations and similar businesses, tianeptine may also be referred to colloquially as "gas station heroin."

The dangers of unregulated tianeptine in the U.S.

Due to a lack of awareness about tianeptine's risks, consumers may unwittingly consume products containing the drug without realizing the potential hazards. People may experience harmful cardiovascular, gastrointestinal, and neurologic effects, often mimicking opioid withdrawal symptoms. In the worst cases, tianeptine exposure can lead to seizures, coma, and even death.

Since 2014, U.S. poison control centers have seen an increase in calls related to tianeptine exposure, and the American Poison Center calls the drug an "emerging threat." Meanwhile, the FDA has raised the red flag, pointing to reports of seizures and hospitalization following the consumption of certain popular formulas containing tianeptine, such as Neptune's Fix.

Tianeptine also has a risk of addiction potential. Part of the issue comes from the drug’s short half-life. Because it leaves the body fairly quickly, it can cause fast withdrawal symptoms, which increases the risk of misuse and possible addiction.

Taking action against tianeptine

A number of states have already taken legal action to minimize tianeptine's threat. Some have banned the drug, while others have severely limited access to it. But since tianeptine can still be acquired illegally, it's important to raise awareness about the topic.

Manufacturers of products with tianeptine draw in consumers by suggesting their products will improve brain function, pain, depression, or anxiety, for instance. These claims are misleading and harmful, but there's little the FDA can do about them.

This is because the FDA's power to regulate dietary supplements is limited. It doesn't evaluate these types of products for effectiveness or safety. The FDA can only ensure these items aren't marked as medical treatments.

As unregulated substances like tianeptine and kratom become more common in everyday retail settings, raising awareness and flagging their risks is critical. Never underestimate the potential effects and, in case of tianeptine exposure, seek emergency medical care.


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