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Is Tianeptine Dangerous?
Side-Effects and Risks of using Tianeptine

A man is sleeping on a table while undergoing inpatient treatment.

Often called Tia or Tiana (Tianna, Tianaa) for short, tianeptine is a drug that has garnered attention in recent years. Tianeptine is an antidepressant that is not approved for medical use in the United States, though it has been increasingly abused recreationally in the U.S. Some people may use it because of its mood-elevating and anxiolytic capabilities. In higher doses, it has also been reported to produce opioid-like effects, including feelings of relaxation and euphoria, which may contribute to its abuse potential. It is also perceived and used by many as a step-down for overcoming addiction to other more potent and dangerous street drugs. However, there are many potential side effects, physical and mental, from misusing this drug.


Tianeptine is often sold as a nootropic, or cognitive enhancer, either as a supposed dietary supplement in pill form or in its different powder forms (sodium or sulfate salt). It is also believed by some to aid with asthma, bowel troubles, dementia and insomnia. Normally, it is taken orally, though it is sometimes snorted, and even injected, which is extremely dangerous.

It is important to note that tianeptine can be perilous when it is used without direction by a medical professional, and it can have serious negative health consequences when it is abused. The FDA has warned consumers about tianeptine, stating it may be as dangerous as opioids.

In This Article

Side effects and symptoms Associated with Tianeptine use

There are several potential dangers associated with tianeptine abuse. Some of the most serious risks include:

Dependence: Tianeptine can be addictive, and people who abuse it may fairly quickly develop a physical and psychological dependence on the drug.

Overdose: It is possible to overdose on tianeptine, which can be life-threatening. Symptoms of a tianeptine overdose may include difficulty breathing, slow or irregular heartbeat, seizures, and loss of consciousness or coma.

Withdrawal: Stopping tianeptine abruptly after using it for an extended period of time can lead to withdrawal symptoms, which may include flue-like symptoms, nausea, vomiting, muscle aches, and tremors, as well as potentially dangerous reactions when stopped more abruptly.

Cardiovascular effects: Tianeptine has been reported to cause a variety of cardiovascular effects, including changes in blood pressure and heart rate, and the cardiotoxicity may increase the risk of heart attack and stroke.

Other effects: Tianeptine abuse may also lead to other negative health consequences, including liver damage, kidney damage, and gastrointestinal problems including strictures and bleeding. When used intravenously, it can be deadly due to its sticky yet coarse nature, the injections often cause severe skin and vein damage sometimes requiring surgery, and there are reports of extensive and permanent damage to blood veins due to frequent injections.

Dangers of Co-using Tianeptine with other drugs -Polydrug Tianeptine

Tianeptine is especially dangerous when combined with other substances. Combining tianeptine with other drugs can increase the risk of serious side effects and may increase the risk of overdose.

For example, the risk or severity of gastrointestinal bleeding can be increased when Tianeptine is combined with Acemetacin, Aceclofenac or Acenocoumarol. And the risk or severity of adverse effects can be increased when Tianeptine is combined with 1,2-Benzodiazepine (Drugbank). Mixing tianeptine with other drugs can also increase the risk of dependence and addiction.

Interestingly, but potentially dangerously as well, grapefruit inhibits a certain part of the metabolism, which may increase the serum concentration of tianeptine making it more potent and dangerous.

Physical, Mental, & Dependency side effects of tianeptine (Zaza, Tianaa, gas station heroin)

Many issues come about from misusing tianeptine. Because it interacts strongly with human brain chemistry, improper use and abuse can lead to severe issues. These issues include physical effects, emotional effects, and mental effects.

Physical Effects

While tianeptine works by interacting with neuroreceptors in the brain, the drug has various mild to moderate physical side-effects. They include nausea, constipation, pain in the abdominal region, headaches, and dizziness. In addition, tianeptine has been shown to potentially provoke physical agitation, vomiting, tachycardia, hypertension, and other issues. High doses can also produce drowsiness, breathing difficulties, and other serious physical effects. 

Mental Effects

Because of its direct interaction with our brain chemistry, tianeptine can affect a user’s mental state. In its intended dosage, the drug is designed to heighten a patient’s mental state, reducing stress and symptoms of depression and anxiety and producing clarity and cognitive improvements, mainly due to its unique ability to increase brain neuroplasticity. However, there are many side effects. This is especially the case when the drug is abused or used in a way other than its intended purpose. If abused, the drug can also produce anxiety, excitability, and even psychosis.

Addiction Risk

While early studies on tianeptine indicated that the drug was less likely to produce addiction, more recent studies have shown that this is not necessarily the case. For this reason, the Food & Drug Administration (FDA) has warned consumers that tianeptine is considered unsafe and can produce addiction in users. Some research has shown that because tianeptine impacts the neurotransmission of dopamine, it has a significant potential for at least mild dependence and addiction in many individuals. This potential for addiction is especially true in patients with a previous history of substance abuse.

Though not as well-known as other addictive substances, there is a documented risk of tianeptine being an addictive drug. Tianeptine  can be abused due to its euphoric and stress-reducing effects in specific dosages, but also because of tianeptine’s short duration of effects, it may compel some to frequent redosing. The potential euphoric effects of high doses (> 100 mg) may cause some users to exceed recommended dosages, which could quickly raise tolerance and propel a vicious upward spiral ultimately intensifying negative side effects. Many users highlight the quick path to extreme tolerance and exponential dosage increase of the drug, so much so that other powerful street drugs can struggle to have an effect while the body is filled with tianeptine.

Difficulty of Tianeptine Withdrawal and Tianeptine Overdose Risk

One of the consequences of tianeptine abuse is that it can produce severe withdrawal symptoms, with many users describing the attempts at withdrawal as “much more excruciating than any other drug withdrawal”. The FDA has warned the public that tianeptine can produce significant withdrawal effects that are very much like those of opioid toxicity and withdrawal (FDA). Some law enforcement officials have described tianeptine as being “worse than heroin”, and one former user described it saying: “Withdrawal and detox was 10 times more severe than any opiate withdrawal” (Consumer Reports).

Many of these withdrawal symptoms can require medical treatment. For individuals with tianeptine dependence, withdrawal can entail anxiety, sweating, myalgias, chills, and even paranoia. There have also been documented cases of overdoses associated with tianeptine. In high doses, tianeptine alone can produce fatal overdoses, and several cases have thus far been reported. Some medical researchers have shown that the danger of overdose is greater in individuals abusing other substances, especially in the case of opioids, alcohol, and benzodiazepines. As such, the potential for withdrawal and overdose makes tianeptine a potentially lethal substance. See our article “All About Tianeptine” to learn more about the strong risk for falling into a cycle of addiction with tianeptine.

Dangerous dosages of Tianeptine

Case reports illustrate instances of problematic forms of consumption, such as intravenous injection or dose escalation exceeding 100x the therapeutic recommendation. Many of the reports of adverse events with tianeptine are characterized by initial adherence to clinical dosing recommendations followed by dose escalation for desired effects (e.g. antidepressant, anxiolytic, euphoric), eventually leading to tolerance and emergence of opioid-like withdrawal symptoms between doses. Other adverse events from case reports and reports to poison-control agencies include dysphoria, anxiety, damage to peripheral venous tissue from injection, and hepatic toxicity. 

Tianeptine-related calls to poison control centers have skyrocketed in recent years. There have been at least 883 since 2015, up from 27 the decade before. Because many adverse events are never reported, the number is probably much higher. And that’s just in the U.S. Records show that the FDA is aware of dozens more deaths and adverse events outside the country.

When taken in dosages of over 100mg, the effects can be more similar to heroin or opiates. For perspective, prescription doses are normally between 25-50mg per day, but recreational doses can be much higher, anywhere from 100 to 3000mg per day. While fatal dosages depend on a user’s characteristics, overdoses have been reported in cases where users and more than 2.0 mg/L in their blood, and the risk of death is multiplied when mixed with certain other drugs.

Getting help for Tianeptine drug addiction or misuse

If you or someone you know may be struggling with unwanted Tianeptine misuse, they may be stuck in a cycle of addiction, which can be almost impossible to break out of alone. Addiction usually causes one to obsess over the substance they have developed a dependency on, and to seek it out and use it at all costs, even when it may be detrimental to them or their relationships. Additionally, most addictions stem from an underlying emotional or mental cause which may need to be addressed professionally and carefully in a thorough and deep manner.

If someone you care about is exhibiting signs of social or emotional deterioration, as well as other behaviors that may hint at a substance misuse or addiction, you might want to help them research the best available options for caring for and recovering from addiction. Someone stuck in a cycle of addiction may need longer term inpatient care, or a lower level of care, depending on their situation and circumstances. This evaluation is best done by a trained and certified addiction treatment specialist or a doctor. All quality addiction rehabilitation facilities provide access to proper evaluation of treatment needs, along with full applicable health screenings.

Along with finding the suitable care options, you may want to turn to an addiction care provider to assist you in finding a way to encourage and convince the one struggling with addiction to go ahead and commit themselves to treatment. This intervention is usually successful only when approached with sincere respect and compassion.