- August 29, 2025
This manuscript is a narrative review, highlighting the dangers of tianeptine and other gas station drugs and underscoring the urgent need to regulate these substances. In the United States, tianeptine, referred to as “gas station heroin,” is an unapproved drug. It is also marketed as a dietary supplement, “research chemical,” or nootropic and is listed as an ingredient in some dietary supplement products.
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. Among the 114 tianeptine-only exposures, excluding withdrawal-related calls, the most commonly reported related clinical effects were neurologic (48.3%), cardiovascular (32.5%), and gastrointestinal (10.5%) (Table 2).
Since tianeptine is not FDA-approved, tianeptine products are not regulated, so there is no knowing how much tianeptine is in a particular product, or if there are contaminants in the product. Because tianeptine is not well-studied, we have a limited understanding of potential drug-drug interactions. Tianeptine is not considered a controlled substance by the Drug Enforcement Agency at this time. Researchers have also hypothesized that depression involves a disruption of long-term synaptic plasticity 36,121. Extensive work has shown that stress impairs the induction of LTP in the hippocampus and prefrontal cortex, while facilitating its induction in the amygdala 37,39,41,85.
And the researchers in New Jersey who analyzed Neptune’s Fix found that the liquid also contained synthetic cannabis and other drugs. 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. At higher dosages, tianeptine works like an opioid (narcotic), affecting opioid and glutamate receptors which results in a short-lived euphoria, or high.
Despite that, some companies are illegally marketing and selling products containing tianeptine to consumers. Tianeptine is an atypical tricyclic antidepressant that is approved in some European, Asian, and Latin American countries primarily for the treatment of MDD. Tianeptine was developed to help increase serotonin uptake in the brain; it can also act as a full agonist at the mu-opioid receptor.
Medical journals and reports to the FDA suggest that bad effects may occur when tianeptine is taken at doses higher than those prescribed in the countries where the drug has been approved. These reports describe U.S. consumers taking daily doses between 1.3 and 250 times the daily tianeptine dose typically recommended in products approved in other countries. 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.
The latest information on products and trends in the convenience-store and foodservice industries. “Nevertheless, tianeptine is being marketed as a ‘research chemical,’ a ‘nootropic’ cognitive enhancer, or a dietary supplement,” the letter said. This section collects any data citations, data availability statements, or supplementary materials included in this article. In a case report by Dempsey et al., LC-MS-MS was also used to detect tianeptine, with a mobile phase consisting of water and 20 mM ammonium formate and methanol and 20 mM ammonium formate. This highlights the possibility of using several methods to identify tianeptine in a given sample 26.
Autopsy analysis using LC-DAD-MS revealed elevated tianeptine concentrations in the blood, urine, liver, and stomach. Examiners attributed the cause of death to suicidal ingestion of tianeptine products linked to serious harm, overdoses, death tianeptine in combination with alcohol consumption. This article provides a basis for understanding the use of tianeptine in the setting of fatal intoxication 25. More recently, a study by Abdullatef et al. offered an alternative method for determining and quantifying tianeptine in bulk and pharmaceutical formulations. The authors used the quenching effect of tianeptine on vilazodone to evaluate the presence and quantity of tianeptine spectrofluorimetrically.
Previously, she wrote for USA Today, where she was selected to help launch the newspaper’s wellness vertical. One explanation for the rise in calls is simply that more Americans are using the products. “It’s kind of this grey area of consumer products, or supplements, where the contents are not regulated or tested the way they would be with a medication,” said Dr. Diane Calello of the New Jersey Poison Information and Education System. Still, under-the-radar firms sell tianeptine in various formulas, often with brand names like Zaza, Tianaa, Pegasus and TD Red.
Ethanol and alprazolam were also identified in quantities consistent with a state of post-mortem decomposition and therapeutic dosing, respectively 9. Cases of non-fatal intoxication with tianeptine have been published in the literature. In one such case, a 36-year-old male was reported to have intentionally injected an unknown amount of tianeptine powder to “see the future” and subsequently became unresponsive. He was successfully reversed with 1 mg IV naloxone administered by emergency responders, two additional 0.4 mg IV doses, and a 0.2 mg/h naloxone infusion administered in the emergency department. Serology studies showed an elevated ethanol concentration of 133 mg/dl and a mildly elevated ALT of 69 IU/l.