In 2018, two young men were found dead in their respective bathrooms in Texas after using a concentrated powder form of tianeptine.
Tianeptine is an antidepressant prescribed in Europe, Asia and South America. It’s banned in the US, but it’s found its way here. The Food and Drug Administration (FDA) issued a warning about the drug’s risks in 2018. Then in February 2022, the agency put out a new warning after scientists found a large increase in calls to poison control centers related to tianeptine poisoning.
What is Tianeptine?
Tianeptine, sold under the brand names of Coaxil and Stablon, is a tricyclic antidepressant. However, it also acts on a particular set of receptors in your brain that are activated by opioids, such as oxycodone or heroin. Thus, it comes with many of the same dangers as opioids, including addiction, dependence, and withdrawal and overdoses, which can be fatal.
‘Available’ Does Not Mean Safe or Approved
Type tianeptine into a Google search, you may notice that it’s not immediately obvious from reading entries that the substance is banned in the US as a dangerous substance, which offers scant benefits. The first three listings in the search are ads to sell the product, then there’s a Wikipedia description of tianeptine without mentioning its banned status.
Some people intentionally seek tianeptine out from online pharmacies that get the drug from outside the US. Those in the market for the drug may be looking to treat depression or anxiety or even opioid-use disorder, which some sellers falsely claim its benefits. The Wikipedia entry, for example, includes claims that tianeptine treats asthma, anxiety and irritable bowel syndrome.
Others may unknowingly purchase the drug, which may be illegally added to supplements, online or at gas stations and convenience stores. It’s not always obvious that a supplement contains tianeptine. It could be contaminated with the substance or use other names such as “Zaza” or “Tianna Red.”
“Unlike most antidepressants that require [a] prescription, this drug is easily accessible and can be bought from gas stations and convenience stores because it is being marketed as a supplement,” says Manish Mishra, Bachelor of Medicine, Bachelor of Surgery (MBBS), the equivalent of an MD in the US, an emergency physician and medical reviewer at of the Addiction Resource blog.
Signs of a tianeptine overdose include:
- Lethargy
- High blood pressure
- Nausea or vomiting
- Abnormal muscle movements
- Agitation
- Sweating
- Confusion
- Slowed, or cessation of breathing
“If someone does use tianeptine and experiences unwanted side effects, contact poison control immediately. There are two ways to contact poison control in the United States: online at www.poison.org or 1-800-222-1222. Both options are free, confidential and available 24 hours a day,” says Kelly Johnson-Arbor, MD, toxicologist and medical director at the National Capital Poison Center.
