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Tianeptine Facts

Antidepressant; Opioid; Benzamide; Mu-opioid receptor agonist

Description

Tianeptine — ZaZa, gas station heroin — is a synthetic antidepressant of the dibenzothiazepine class. It activates opioid receptors in the brain, producing quiet mood correction at therapeutic doses and sedation and euphoria at high ones.

Subjective effects include mood elevation, anxiety relief, sedation, and euphoria. At prescribed doses the experience is quiet — a background reduction in distress without a recognizable high; at high doses, opioid warmth and heavy sedation take over.[1]

At high doses tianeptine produces severe physical dependence and dangerous respiratory depression.[2] The short half-life drives withdrawal between doses, pushing users from milligrams to grams within weeks; combining with alcohol or other sedatives amplifies overdose risk.[3]

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 5 mgLight12.5 – 25 mgCommon25 – 50 mgStrong50 – 100 mgHeavy100+ mg

Starts in 15 – 30 minLasts 2 – 4 hoursAfter-effects 2 – 5 hours

Body and dependence

Acute toxicity
Moderate
Chronic toxicity
Moderate
Physical dependence
High
Psychological dependence
High
Withdrawal
Severe · medical supervision
Compulsive redosing
High

Tolerance

Builds
Rapid
Fully resets after
Not recorded
Carries over to
morphine; oxycodone; hydrocodone; heroin; tramadol; codeine; fentanyl

Effectslikely at a common dose

Perception
none likely · 2 possible
Body
Body high; Pain suppression; Pupil constriction; +28 possible, including Nausea, Insomnia, Dizziness
Thinking
Compulsive redosing urge; +12 possible, including Cognitive dysphoria, Cognitive impairment, Confusion
Feeling
Anxiety suppression; Euphoria; Anxiety; Irritability; +4 possible, including Anhedonia, Depression, Dysphoria
Self
Craving; +2 possible, including Social disconnection

Who shouldn't take it

Absolute
Pregnancy; Concurrent opioid use
Relative
Respiratory insufficiency; Severe renal impairment; Elderly; Alcohol use disorder; Concurrent benzodiazepine or CNS depressant use

Combinations60 recorded

Lethal (4)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Local anesthetics
Dangerous (28)
Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antihistamines; Antipsychotics; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Clonidine, Guanfacine; Gabapentin, Pregabalin; MAOIs; MDMA, Amphetamines; MDMA, MDA; Naltrexone; NRIs; SNRIs; SSRIs; Stimulants; Synthetic cannabinoids; THC; Caffeine; CBD; Glutamate modulator; Huperzine A; and 4 more, see full page
Caution (20)
See full page: psychedex.org/substances/tianeptine
Not graded (8)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Gassaway MM, Rives ML, Kruegel AC, Javitch JA, Sames D (2014) The atypical antidepressant and neurorestorative agent tianeptine is a mu-opioid receptor agonist — Translational Psychiatry doi:10.1038/tp.2014.30
  2. [2]
    ^Marraffa JM, Stork CM, Hoffman RS, Su MK (2018) Poison control center experience with tianeptine: an unregulated pharmaceutical product with potential for abuse — Clinical Toxicology doi:10.1080/15563650.2018.1476694
  3. [3]
    ^Proenca P, Teixeira H, Pinheiro J, Monsanto PV, Vieira DN (2007) Fatal intoxication with tianeptine (Stablon) — Forensic Science International PMID:17630235
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