FDA Warns Against “Gas Station Heroin” Tianeptine

The FDA’s recent warning about tianeptine – or “gas station heroin”--  highlights the risks of serious harm or death, prompting patient questions. Here’s what you need to know. 

What is tianeptine? Tianeptine is an atypical antidepressant available as a prescription medication in some European, Asian, and Latin American countries but remains unapproved by the FDA for use in the United States. Despite this, it is available at gas stations, convenience stores, and vape shops. People often misuse it for a variety of reasons including as an opioid replacement or to self-treat anxiety or depression. Tell patients that these unregulated products can have inconsistent content and purity, creating serious safety risks. What’s more, people seeking opioid-like effects often take much higher doses than the therapeutic range of 25 to 37.5 mg used for depression treatment in other countries.

What are the risks with tianeptine use? Reports have linked its use to abuse, dependence, and withdrawal symptoms. Beyond these concerning patterns of misuse, patients may experience common adverse effects, but it is important to alert them to the more serious adverse effects including confusion, coma, liver damage, and death.

What drug interactions and precautions are concerning? Always check if they have any history with addiction or substance abuse since tianeptine can be highly addictive and cause severe withdrawal with long-term use. Also, a major drug interaction occurs with monoamine oxidase inhibitors – though these aren’t prescribed as frequently – the combination can cause life-threatening events like cardiovascular collapse, convulsions, and death.

To dive deeper into the safety and effectiveness of tianeptine, follow up with the latest monograph and don’t miss out on the upcoming CE covering supplements of abuse.