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How Tianeptine Supplements Feed the Opioid Epidemic

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 14, 2023 • 4 cited sources

Tianeptine is an antidepressant medication used in Europe but not the United States. Its pharmacology is somewhat complicated, as it shares the properties of both tricyclic antidepressant and opioid medications. 

Whether you’re in recovery from an opioid use disorder (OUD) or you’ve never taken opioids before, these pills are dangerous. They can trigger many of the same reactions opioids do. 

Tianeptine is not regulated here in the U.S., so each pill also could be dangerous due to contamination. You may not know what’s inside the doses you take. 

Tianeptine misuse is on the rise in the United States.[1] Here’s what you need to know. 

What Is Tianeptine?

Tianeptine is an atypical antidepressant that also has some opioid properties. It has a half-life of two to four hours.[2] It’s not prescribed in the U.S. Instead, it’s considered a dietary supplement and is included in products like ZaZa Red or Tianna.

Tianeptine products are regulated via the 1994 Dietary Supplement Health and Education Act (DSHEA). Under DSHEA, pre-market testing is not required to assess the purity, efficacy or safety of substances marketed as supplements. Manufacturers also don’t have to tell their customers about the harm their products can cause.

Tianeptine works on opioid receptors, and it’s inherently dangerous. But manufacturers aren’t required to disclose this fact on their labels.

How Is Tianeptine Used?

The United States Food and Drug Administration (FDA) hasn’t approved tianeptine for any medical or commercial use, but it’s moved into the United States anyway. 

Officials have encountered tianeptine products in stamp bags typically used to distribute heroin.[3] This packaging suggests some people buy the drug from dealers, or they buy bags they think contain heroin but that contain something else instead. 

Experts say tianeptine is also sold in the United States via online merchants, and in some states, it’s sold in convenience stores in packages that suggest it could make you smarter or more focused.[1] People who buy these packages may think they’re using a safe herbal supplement to make them perform better at work or school. 

In Europe, some people may use tianeptine with a prescription to ease depression. But in the United States, people may use the drug for varied reasons that have nothing to do with easing disease. 

Dangers of Tianeptine for Those With OUD

Any supplement you buy could be dangerous because the FDA doesn’t regulate supplements like medications. Tianeptine could be particularly risky for people with an OUD for the following reasons:


Substances that claim to contain tianeptine can often contain other substances or other opioids instead. If you purchase tianeptine illegally, you don’t really know what substance you are getting or how much.[3] 

Risk of Opioid Misuse

You might buy tianeptine products to treat cravings or withdrawal symptoms from opioids. However, tianeptine has misuse potential for people in recovery from OUDs.[4]

Risk of Overdose 

Tianeptine is an opioid medication and thus carries the same risks as other opioids, including respiratory suppression and overdose. 

How to Stay Safe 

Don’t trust supplement suppliers. If you can’t tell exactly what’s inside a packet or pill you’re about to buy, don’t take it.

If you’re tempted to use tianeptine to treat an OUD, reach out to your doctor. There are much safer, regulated, FDA-approved medications to treat OUD that are available to you. We’re also ready to help you here at Bicycle Health.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Tianeptine Use: Another Dangerous Substance Emerges During Opioid Crisis. Healio. December 2020. Accessed February 2023.
  2. Pharmacokinetic Study of Tianeptine and Its Active Metabolite MC5 in Rats Following Different Routes of Administration Using a Novel Liquid Chromatography Tandem Mass Spectrometry Analytical Method. Naunyn-Schmiedeberg's Archives of Pharmacology December 2017. Accessed February 2023.
  3. Tianeptine. Drug Enforcement Administration. January 2023. Accessed February 2023.
  4. Characteristics of Tianeptine Exposures Reported to the National Poison Data System, United States, 2000 to 2017. Centers for Disease Control and Prevention. August 2018. Accessed February 2023.

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