Tianeptine—sometimes called ‘gas station heroin’—has been linked to growing reports of dependence, withdrawal, and even overdoses. As more states move to ban it and the FDA cracks down on misleading marketing, it’s important to understand what this drug is, why it’s dangerous, and what to do if you or someone you love is struggling with addiction.
What Is Tianeptine?
Tianeptine was developed in the 1960s as an antidepressant, and it is still prescribed in some countries for major depressive disorder and anxiety. However, it is not approved for medical use in the United States. Despite this, it’s gained a reputation as a highly addictive substance of abuse, earning nicknames like “gas station heroin” due to its powerful opioid-like effects.
Unlike traditional antidepressants, tianeptine binds directly to the brain’s opioid receptors, mimicking the effects of prescription painkillers and even illicit opioids like heroin and fentanyl. This mechanism is similar to tramadol, a prescription painkiller that also has antidepressant-like properties due to its dual action on opioid receptors and neurotransmitter systems. Like tramadol, tianeptine’s combination of opioid activity and mood effects makes it highly addictive, creating both a physical dependence and a powerful mental attachment that makes withdrawal especially difficult. (Read more about the dangers of atypical opioids like tramadol here.)
Although it is unregulated and not approved for medical use, it is often marketed (misleadingly) as a dietary supplement or nootropic under names like “ZaZa,” “Tianaa,” “Tianna Red,” “Pegasus,” “Red Dawn,” and is widely available online and in gas stations, smoke shops, and convenience stores. Because it is so easily accessible, many users mistakenly believe it is safe—only to find themselves trapped in a cycle of addiction, withdrawal, and severe health consequences.
Why Is Tianeptine Such a Problem?
The rise in tianeptine abuse stems from its powerful opioid-like effects and its abundant availability compared to prescription and illicit opioid drugs. Some individuals turn to tianeptine to self-medicate for depression, anxiety, or opioid withdrawal, believing it to be a safer alternative. However, because tianeptine directly affects opioid receptors, tolerance builds rapidly, forcing users to escalate their doses just to maintain the same effects.
Once dependence sets in, withdrawal symptoms can be severe, making it extremely difficult to quit without professional help. This rapid cycle of escalating use and withdrawal avoidance drives compulsive drug-seeking behavior, similar to traditional opioids. Several states have already moved to ban tianeptine, recognizing its dangers. However, it remains available in many areas, putting countless people at risk.
The main dangers associated with tianeptine include:
- High potential for addiction – People rapidly develop dependence, requiring larger doses to feel the same effects.
- Severe, complex withdrawal symptoms – Those who try to stop using it experience both intense physical withdrawal and psychological distress.
- Unregulated & unpredictable nature – Because it’s often sold as a supplement, potency varies widely between products.
- Easy accessibility – Unlike prescription opioids, tianeptine is widely available in gas stations and online.
- High risk of overdose – Taking high doses or mixing it with other substances (like alcohol or benzodiazepines) can be fatal.
Signs & Symptoms of Tianeptine Use
Because tianeptine acts on opioid receptors, it produces effects similar to opioid painkillers like oxycodone and heroin. In small doses, it may enhance mood or reduce anxiety, but as tolerance builds, users take larger amounts—leading to a range of dangerous effects.
Many people begin using tianeptine believing it to be a safer alternative or a way to manage anxiety, depression, or opioid withdrawal. However, its opioid-like effects quickly lead to physical and psychological dependence, making it just as dangerous as traditional opioid and leading to severe withdrawal symptoms when they try to quit.
Common symptoms of tianeptine use:
- Increased energy or motivation (early stages of use)
- Drowsiness or sedation (with high doses)
- Slurred speech
- Nausea and vomiting
- Dry mouth
- Sweating
- Dizziness or confusion
Withdrawal from Tianeptine: What to Expect
Stopping tianeptine after developing an addiction is extremely difficult. Withdrawal symptoms are often severe and long-lasting, closely resembling those of opioid withdrawal. However, what makes tianeptine withdrawal particularly distressing is that, beyond the physical symptoms, many users experience intense psychological dependence, feeling as though they cannot function without the drug. The combination of physical discomfort and overwhelming mental distress makes quitting even more challenging.
The withdrawal process is not only grueling but also reinforces compulsive drug-seeking behavior. Intense cravings, anxiety, and emotional distress drive many individuals back to using, making relapse a significant risk without proper medical support. Because withdrawal can be so extreme, many people continue using simply to avoid suffering, trapping them in a cycle of dependence that can be incredibly difficult to break without professional intervention.
Common withdrawal symptoms include:
- Severe anxiety & panic attacks
- Depression & suicidal thoughts
- Extreme fatigue
- Intense cravings
- Nausea & vomiting
- Diarrhea
- Profuse sweating & chills
- Muscle pain & body aches
- Restlessness & insomnia
- Heart palpitations
- Elevated blood pressure
Tianeptine Overdose: Signs & Risks
Taking too much tianeptine can lead to a life-threatening overdose, much like traditional opioids. Overdose occurs when the drug slows breathing and heart rate to dangerously low levels, which can result in loss of consciousness or even death. However, tianeptine’s effects extend beyond typical opioid toxicity.
Unlike traditional opioids, tianeptine also influences serotonin and norepinephrine levels, meaning an overdose may not always present as purely respiratory depression. In some cases, symptoms can include agitation, high blood pressure, or seizures alongside slowed breathing. The risks are even greater when tianeptine is purchased from unregulated sources, as potency and purity can vary. Even what seems like a “normal” dose can lead to overdose, and mixing tianeptine with alcohol, benzodiazepines, or other opioids significantly increases the likelihood of fatal respiratory failure.
Symptoms of tianeptine overdose include:
- Extreme drowsiness or unconsciousness
- Slow, shallow, or stopped breathing
- Bluish or grayish skin, lips, or fingernails (due to lack of oxygen)
- Weak pulse or low blood pressure
- Vomiting while unconscious
- Seizures
- Confusion or inability to respond
How Enterhealth Can Help
Tianeptine addiction is real, dangerous, and difficult to overcome without medical support. At Enterhealth, we provide expert, science-backed treatment to help individuals break free from dependence safely and effectively.
Our comprehensive approach includes:
- Medically supervised detox – Our medical team ensures that withdrawal is safe, as comfortable as possible, and medically managed to prevent complications. LEARN MORE
- Inpatient and outpatient treatment – We offer structured, evidence-based programs designed to help individuals recover at their own pace. LEARN MORE
- Therapy and counseling – Our expert therapists address the root causes of addiction with individual, group, and family therapy. LEARN MORE
- Relapse prevention strategies – We help clients build the tools they need to maintain long-term sobriety and mental wellness. LEARN MORE
If you or a loved one is struggling with tianeptine addiction, help is available. Enterhealth’s team of addiction experts can provide personalized, compassionate care that leads to real recovery. Contact us today to learn more.
