How Does Tianeptine Work?
Tricyclic antidepressants are one of the first kinds of antidepressant medications. They were introduced in the 1950s. They work by keeping serotonin and norepinephrine brain levels high. Even though it is classified as a tricyclic antidepressant, tianeptine works differently to other drugs in that class. Recently discovered, tianeptine connects to the opioid receptors in the brain, just like drugs such as heroin and prescription opioid pain medicines. Because of how tianeptine works, people can get high using it.Recreational tianeptine use is now becoming a problem.
The opioid crisis in the United States is still going strong, with most people knowing about the dangers of prescription opioid abuse, heroin, and fentanyl.
However, there is a new danger on the recreational drug use scene – tianeptine.
People are using tianeptine as an opioid replacement. The Food & Drug Administration (FDA) in the U.S. has now warned the nation’s consumers about this unapproved drug, currently found in dietary supplements, advising them that the drug is certainly not a safe alternative to opioids.
What is Tianeptine?
Tianeptine is a tricyclic antidepressant. Other countries use it to treat major depressive disorder. Discovered in France during the 1960s, it has been on the market for a while. It is available in some other European countries, Asia, and Latin America.
Foreign brand names for Tianeptine include:
- Coaxil
- Tatinol
- Stablon
- Neluptin
- Neptika
- Tialera
- Aneptinex
- Lyxit
Why is Tianeptine Dangerous?
Why is Tianeptine Dangerous?
People using large amounts of tianeptine can poison themselves. The FDA reports adverse effects are possible. It happens when people use more than what is prescribed in other countries.
A CDC study reported a rise in calls to poison control centers because of tianeptine. The study begins with calls in the year 2000. The last year of the study includes calls from 2017.
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Over 17 years, there have been 218 calls reported about tianeptine. Only 11 calls are from the years 2000-2013. 207 calls to poison control happened in the last 4 years of the study.
Most of the calls to poison control, 91.2%, came from health care providers. This suggests that people went to the hospital because of tianeptine.
In 2020, there were 151 calls to poison control about tianeptine. All of this information was given voluntarily to poison control. There could be many people who have had unreported serious reactions to tianeptine.
FDA Warns Two Companies Using Tianeptine
After the CDC study in 2018, the FDA sent warning letters to 2 companies. These 2 companies were making dietary supplements. They were warned about using tianeptine in their products. Dietary supplements have to have a single dietary ingredient.
This can include:
- Mineral
- Vitamin
- Herb
- Other botanical substance
- Amino aci
Dietary supplements can include non-dietary ingredients. These ingredients must meet food additive guidelines, or an ingredient must be considered generally recognized as safe (GRAS).
Tianeptine does not meet any of the requirements to be included in a dietary supplement.
There is another reason theFDA sent warning letters to the companies. They claimed their supplement could cure opioid use disorder. It is not legal for companies to claim their supplement can cure a disease.
People who have opioid use disorder need to seek professional treatment – primarily because opioid withdrawal is dangerous. The detox process must be taken very seriously.
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Side Effects of Using Tianeptine
When people use small amounts of tianeptine, there does not seem to be a negative reaction. When people use enough to get high like an opioid, there are serioussafety risks. When people stop using tianeptine, they have withdrawal symptoms.
Side effects of tianeptine include:
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- Drowsiness
- Agitation
- Sweating
- Confusion
- Nausea
- Vomiting
- Rapid heartbeat
- High blood pressure
- Slowed or stopped breathing
- Coma
- Death
Tianeptine Case Study Reports Showing Dangerous Reactions
A CNN article from 2018 includes a doctor’s case study. The case study reports a 42-year-old man was found unresponsive by his wife. He had been using tianeptine.
He was given naloxone in the ambulance, which woke him up. At the hospital, the man said he took more tianeptine than usual. He was using it for chronic back pain.
Anotherstudy looked at poison control call data. This study included calls from January 1, 2015, to March 15, 2020. Of all the calls relating to tianeptine, 48 were reviewed.
Of those 48 cases, 37 of them happened between May 2019 and March 2020. More than half of the cases needed hospital care. 17 cases were treated in an intensive care unit. Naloxone was used in 4 of the cases.
A CDC report from 2018 includes the death of a California man. A 24-year-old man was found unresponsive on October 10, 2017. He was transported to the hospital, he remained in a coma. The patient had a 2-year history of tianeptine misuse.
patient had a 2-year history of tianeptine misuse.
Serum levels from a sample taken on October 10th, 2018, showed a tianeptine level of 3000 ng/mL.
The therapeutic range is only 278-366 ng/mL.
An MRI showed toxic leukoencephalopathy. This is brain damage in the white matter. It is caused by environmental toxins, substance use, or chemotherapeutic drugs. The man died 19 days after entering the hospital.
An additionalcase report includes 2 deaths connected to tianeptine. In these cases, a 28-year-old man and a 30-year-old man. Both were from Texas. Both men were found unresponsive in their own homes. Drug paraphernalia and bags labeled as tianeptine were nearby.
How Do People Get Tianeptine in the United States?
Tianeptine is easy to find on the internet. Dealers can buy it in bulk online, and then sell it on the street.
Supplement companies still include it in some products. Supplements do not need FDA approval before entering the marketplace. Some of these supplements can be bought in gas stations across the United States.
When looking at ingredients people should know tianeptine is also called:
- Tianaa
- Tianaa Green
- Tianaa Red
- Tianaa White
- Tianeptine sodium powder
- Tianeptine sulfate
- ZaZa
What Should I Do If I Have Taken Tianeptine?
What Should I Do If I Have Taken Tianeptine?
If you are having a dangerous reaction, such as breathing problems, call 911. If you think someone else is overdosing on tianeptine, call 911 right away. Naloxone could save their life, just like it can during an opioid overdose.
For other side effects like vomiting, call poison control or your medical provider.
If you have been using tianeptine in the past, stop using it. If you have been using large amounts or for a long time, you may need help to stop. Tianeptine has withdrawal symptoms similar to opioids.
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If you are using supplements regularly, check the ingredients list – especially if a supplement claims to improve brain function. If tianeptine is one of the ingredients, stop using that supplement.
Withdrawal Symptoms
Tianeptine connects to the same receptors in the brain as opioid drugs. This means withdrawal symptoms are going to be similar.
Opioid withdrawal symptoms include:
- Anxiety
- Agitation
- Insomnia
- Sweating
- Muscle aches
- Abdominal cramping
- Diarrhea
- Nausea
- Vomiting
- Goosebumps
- Watery eyes
- Runny nose
- Restlessness
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Getting Help for Tianeptine Misuse
The number of people misusing tianeptine to replace opioids is increasing. This is a dangerous situation. Quitting tianeptine can be just as hard as quitting opioids.
Most people need help to stop an addiction. Seeking professional help is a smart move. If withdrawal symptoms are severe, medical care is needed.
Going to rehab helps people understand why they were using a substance.
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This is an important part of recovery. When they understand why they are using it, they can change their habits.
Often people misuse drugs as a way to self-medicate. With tianeptine, someone might need help with anxiety or depression. A substance use problem and a mental health issue can happen at the same time. This is called having a co-occurring disorder.
Traveling for Rehab
For many people, traveling for rehab is a good option. People can choose to travel for many different reasons.
They might not have a safe home environment. Going out of town means they can focus on rehab. They can be in a place where they feel safer to work on their problems.
Professionals can have substance use problems. It can happen to anyone. They might choose to go out of town for privacy. They can get the help they need without being the subject of gossip.
A change of location can help avoid relapses. A relapse is when someone starts using drugs or alcohol again. Being near places where someone used drugs could bring the temptation to start again. This can be the same for people they used drugs with.
Being away from other obligations might be a reason to travel for rehab. This allows a person to focus only on their recovery.
Sober Living Options
A sober living home can be a good option for people recovering from tianeptine misuse. A sober living house is a community house specifically for people in recovery. This can be an important option for someone who would go home to others still using drugs.
Each sober living house has strict rules. No drugs or alcohol use is allowed at the home. Usually, residents will be expected to help out around the house. They may still need to be attending a treatment program while living there.
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External Sources:
- PubChem. Tianeptine. 2022. Available atpubchem.gov.
- Drugs.com. Tianeptine. 2022. Available atDrugs.com/international.
- Healthline. Tricyclic Antidepressants. September 2, 2018. Available atHealthline.com.
- Drug Enforcement Administration. Tianeptine. May 2019. Available atUSDOJ.gov.
- Centers for Disease Control & Prevention (CDC). Characteristics of Tianeptine Exposures Reported to the National Poison Data System- United States, 2000-2017. August 3, 2018. Available atCDC.gov.
- U.S. Food & Drug Administration (FDA). FDA 101: Dietary Supplements. July 15, 2015. Available atFDA.gov.
- U.S. Food & Drug Administration (FDA). FDA Takes Action on Products Marketed as Dietary Supplements Containing Tianeptine and Warns Consumers. November 20, 2018. Available atFDA.gov.
- U.S. Food & Drug Administration (FDA). Tianeptine Products Linked to Serious Harm, Overdoses, Death. February 10, 2022. Available atFDA.gov.
- National Library of Medicine. Characteristics of Tianeptine Effects Reported to a Poison Control Center: a Growing Threat to Public Health. June 18, 2020. Available atPubMed.gov.
- Centers for Disease Control & Prevention (CDC). Notes From the Field: Toxic Leukoencephalopathy Associated with Tianeptine Misuse- California 2017. Available atCDC.gov.
- National Library of Medicine. Case Reports of Fatalities Involving Tianeptine in the United States. September 1, 2018. Available atPubMed.gov.
- U.S. Food & Drug Administration (FDA). Tianeptine in Dietary Supplements. November 20, 2018. Available atFDA.gov.
- Medline Plus. Opiate and Opioid Withdrawal. May 10, 2020. Available atMedlinePlus.gov.
Author: ridinghood
MAY 6, 2022