Tianeptine

In the United States, tianeptine, referred to as “gas station heroin,” is an unapproved drug. It is also marketed as a dietary supplement, “research chemical,” or nootropic and is listed as an ingredient in some dietary supplement products. It is sold online and in stores—including in some gas stations and vape shops. According to the Food and Drug Administration (FDA), companies are making dangerous claims that tianeptine can improve brain function and treat depression, anxiety, pain opioid disorder, and other conditions. In the illicit drug market, it has been found in counterfeit pills mimicking hydrocodone and oxycodone and in small packets commonly used to distribute heroin. It is not approved in the United States for any medical use, despite its approval to treat certain conditions in other countries.

Tianeptine is on the DoD Prohibited Dietary Supplement Ingredients List, and serious health risks, including death, have been associated with its use.

Tianeptine is addictive and often abused for its euphoric effects. Overdoses, death, and serious health issues have been reported. Other adverse effects could include:

• Agitation
• Coma
• Confusion
• Drowsiness
• Nausea
• Rapid heartbeat
• Slowed or stopped breathing
• Sweating
• Vomiting

Withdrawal from tianeptine is similar to opioid withdrawal and may result in severe symptoms that can require hospitalization. Tianeptine abuse has been increasing over the past 2 decades, which has prompted warnings from FDA and the Drug Enforcement Administration (DEA). For more information about tianeptine, please read the factsheet from DEA included below, along with the recent trend alert, warning, and article from FDA.

Tianeptine testing is available through the Armed Forces Medical Examiner System, Division of Forensic Toxicology.

Posted 21 April 2023

Updated 16 July 2025