Published
Medically reviewed by Danesh Alam MD, DFAPA, DFASAM
Tianeptine is an antidepressant prescribed in some countries but never approved by the FDA for any use in the United States. Here it is sold in gas stations, vape shops, and online as Tianaa, Zaza, Neptune's Fix, and other brands. At high doses it acts like an opioid, and regular use can lead to dependence, withdrawal, and overdose.
If someone cannot be woken or is not breathing normally, call 911 now and give naloxone if you have it.
What is tianeptine?
The FDA says that in some countries tianeptine is "licensed and marketed as an atypical antidepressant," and that it is "a full mu- and weak delta-opioid receptor agonist." Where it is approved, the usual dose is 12.5 mg three times a day, and some countries have added addiction warnings. FDA: "Gas station heroin" tianeptine letter
The Department of Health and Human Services (HHS) notes that it is approved in parts of Europe, Asia, and Latin America, but no tianeptine product is approved for medical use in the U.S. DEA: Proposed rule to schedule tianeptine
Why is tianeptine called "gas station heroin"?
It got the nickname because it is sold in gas station stores and acts like an opioid. The FDA lists Tianaa, Zaza, Neptune's Fix, Pegasus, and TD Red as examples, also sold at convenience stores, vape shops, and online. Sellers market it as a "research chemical," a "nootropic" brain booster, or a dietary supplement. The FDA says it is not an approved drug, not a safe food ingredient, and not a legal supplement ingredient. FDA: "Gas station heroin" tianeptine letter
The doses are far higher than those prescribed abroad. The FDA notes case reports of people in the U.S. taking 50 mg to 10,000 mg a day, or 1.3 to 250 times the usual daily dose. The DEA reports that some product labels list hundreds to more than 1,000 mg in a single unit. DEA: Proposed rule to schedule tianeptine
Many people don't buy it to get high. The FDA says vendors make "unproven claims" that tianeptine treats anxiety, depression, pain, and opioid use disorder. Some people turn to it "as an opioid alternative, or to self-treat anxiety or depression." FDA: Tianeptine products linked to serious harm HHS found that more people sought it for hoped-for health benefits, such as pain relief or quitting opioids on their own, than for recreation. DEA: Proposed rule to schedule tianeptine
Our guide to what 7-OH is covers the concentrated kratom pills sold in the same stores, and our post on Galaxy Gas and nitrous oxide covers another smoke-shop risk.
Is tianeptine an opioid?
It is not built like an opioid, but at high doses it acts like one. The DEA describes tianeptine as structurally a tricyclic antidepressant. It also notes case reports of people using it for euphoria "similar to other opioids, such as heroin, morphine, and fentanyl." In animal studies, it acts on mu-opioid receptors much like morphine does, though it is less potent. At the high doses seen in misuse, it can slow breathing the way other opioids do. DEA: Proposed rule to schedule tianeptine
It also wears off quickly. The DEA reports a half-life of about 2.5 hours, and law enforcement reports describe people dosing more often than with heroin because the effect is shorter.
The FDA warns that people with a history of opioid use disorder or dependence "may be at particular risk." FDA: Tianeptine products linked to serious harm If you or a family member started using tianeptine to manage opioid withdrawal, our page on opioid addiction treatment explains care options.
What has the FDA said about tianeptine?
The FDA has told consumers not to buy or use any tianeptine product. It first warned the public in November 2018, according to the DEA. DEA: Proposed rule to schedule tianeptine Since then:
- November 2023: The FDA warned consumers not to use Neptune's Fix or any other tianeptine product. It noted that Neptune's Fix "may contain other harmful ingredients not listed on the label."
- January 2024: The FDA reported seizures, loss of consciousness, and deaths after Neptune's Fix use. Neptune Resources recalled all its Neptune's Fix products, and the FDA urged gas stations and convenience stores to stop selling any tianeptine product.
- May 2025: The FDA updated its warning and named more brands, including Tianaa and Zaza. FDA: Warning on tianeptine products
That month, the FDA Commissioner also wrote to health care professionals about a "dangerous and growing health trend," with particular concern for young people. FDA: "Gas station heroin" tianeptine letter
Labels can't be trusted. In 2023, a New Jersey poison center saw 17 people with severe illness after taking tianeptine, mostly Neptune's Fix. Thirteen went to intensive care, and seven needed a breathing tube. Lab tests found synthetic cannabinoids in some bottles that were not on the label. CDC MMWR: Neptune's Fix cluster in New Jersey
How common are tianeptine poisonings?
They are rising fast. The FDA reports that tianeptine cases at U.S. poison centers grew from 4 in 2013 to about 350 in 2024. FDA: Tianeptine products linked to serious harm
A 2025 study of poison center data found the exposure rate rose 1,400% from 2015 to 2023. About 40% of people needed hospital admission, nearly 23% went to a critical care unit, and withdrawal accounted for about 22% of cases. Rates were highest in the South. Journal of Medical Toxicology: Tianeptine exposures, 2015–2023
What does tianeptine withdrawal feel like?
It feels like opioid withdrawal. The FDA says people who use tianeptine regularly and stop suddenly may have symptoms "similar to those associated with opioid discontinuation," such as craving, sweating, goosebumps, diarrhea, and muscle aches. FDA: "Gas station heroin" tianeptine letter The DEA notes that tianeptine is linked to both psychological and physical dependence. Severe withdrawal has led to hospital stays. DEA: Proposed rule to schedule tianeptine
MedlinePlus lists these early signs of opioid withdrawal:
- Anxiety and agitation
- Muscle aches
- Trouble sleeping
- Runny nose, watery eyes, and yawning
- Sweating
Later signs can include stomach cramps, diarrhea, nausea, vomiting, goosebumps, and dilated pupils. MedlinePlus: Opioid withdrawal
No approved source has set out a timeline for tianeptine withdrawal. Talk with a doctor before stopping rather than quitting alone.
The time after withdrawal carries its own risk. MedlinePlus notes that "most opioid overdose deaths occur in people who have just detoxed," because tolerance drops. Returning to an old dose, or switching to another opioid, can be dangerous.
Can you overdose on tianeptine?
Yes. The FDA lists slowed or stopped breathing, coma, and death among reported harms, both with tianeptine alone and mixed with other drugs. FDA: Tianeptine products linked to serious harm A 2025 review of published cases found overdoses often involved very high doses, sometimes with alcohol or benzodiazepines. BMC Public Health: Tianeptine systematic review
Naloxone may help. HHS has noted that naloxone has reversed tianeptine overdose in some cases. DEA: Proposed rule to schedule tianeptine Naloxone is sold over the counter in all 50 states. It "won't harm someone if they're overdosing on drugs other than opioids," so use it whenever you suspect an overdose. CDC: Lifesaving naloxone
Signs of an opioid-type overdose include being unable to wake up, slow or shallow breathing, choking sounds, discolored lips or nails, and pinpoint pupils. If you see them: CDC: Responding to an overdose
- Give naloxone if you have it, and call 911.
- Try to keep the person awake and breathing.
- Lay them on their side to prevent choking.
- Stay with them until help arrives.
Read more about the signs of an overdose, how Narcan and naloxone work, and xylazine and nitazenes in the drug supply. For questions about a possible tianeptine reaction, call Poison Help at 1-800-222-1222.
Is tianeptine legal in Florida?
No. Tianeptine is a Schedule I controlled substance in Florida. That is the state's strictest category, for drugs with "a high potential for abuse" and "no currently accepted medical use." Florida Statutes 893.03 Florida first scheduled tianeptine by emergency rule in September 2023. Florida Administrative Register: Rule 2ER23-1 The Legislature then wrote it into law. Chapter 2024-20 added tianeptine to Schedule I, effective July 1, 2024. Laws of Florida: Chapter 2024-20 This is general information, not legal advice.
Is tianeptine illegal federally?
Not yet, but the DEA has proposed adding it to Schedule I. On July 8, 2026, the DEA proposed placing tianeptine in Schedule I of the federal Controlled Substances Act, as HHS recommended in July 2025. Public comments closed August 7, 2026. As of November 5, 2026, no final rule had been published, so check for updates. DEA: Proposed rule to schedule tianeptine The DEA lists Florida among at least 15 states that have already controlled or banned tianeptine.
How is tianeptine addiction treated?
Treatment starts with a medical assessment, and for many people that means supervised withdrawal followed by ongoing care. There is no standard, tested treatment made for tianeptine. A 2026 systematic review found that nearly all published evidence comes from case reports, in which some patients were treated long term with buprenorphine and one with methadone. Drug and Alcohol Dependence: Tianeptine systematic review In another 2026 report, buprenorphine did not control one woman's cravings, and she was switched to methadone. Journal of Addiction Medicine: Methadone for tianeptine use disorder These are individual cases, not proof of what works for everyone.
Care also has to address why someone started. The FDA encourages doctors to talk with patients about "evidence-based treatment options for opioid use disorder, depression, anxiety, or pain." FDA: "Gas station heroin" tianeptine letter If tianeptine started as a way to cope with depression or anxiety, dual diagnosis treatment addresses substance use and mental health in one plan.
Frequently asked questions
Is tianeptine an antidepressant?
Yes, in parts of Europe, Asia, and Latin America. It has never been approved for any use in the U.S.
Is tianeptine addictive?
It can be. Regular use can lead to physical and psychological dependence, and stopping can cause opioid-like withdrawal.
Does tianeptine show up on a drug test?
Often not. The FDA says it "may not be identified in routine drug screening panels." Tell your doctor if you use it.
Does naloxone work on tianeptine?
Naloxone has reversed tianeptine overdose in some cases. It is safe to give even if you're unsure what the person took. Always call 911 too.
Is tianeptine legal in Florida?
No. Florida first scheduled it in September 2023, and it has been a Schedule I substance in state law since July 1, 2024. It is not yet federally controlled, but the DEA has proposed adding it to Schedule I.
Getting help at Ambrosia
Midwest Detox at Ambrosia in West Palm Beach provides detoxification with 24/7 medical supervision by physicians and nurses, for adults and adolescents. Admission and the plan of care are based on an individual clinical assessment. Our medical detox program page explains the first days. Medication-assisted treatment is provided through our detox center, and whether it is right for you is a clinical decision. You can also check your insurance coverage.
For free, confidential treatment referrals at any hour, call SAMHSA's National Helpline at 1-800-662-4357, in English or Spanish. SAMHSA: National Helpline If you or someone you love is in emotional crisis, call or text 988. 988 Suicide & Crisis Lifeline