Jeffrey Panko NP Psychiatry · Patient education
Tianeptine
International prescription antidepressant / Not FDA-approved
A guide for adults taking tianeptine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Regulated oral tablets in some countries have strict prescribing controls. Unregulated powders, liquids, and capsules may have uncertain contents or strength.
What it is used for
Tianeptine is prescribed for depression in some countries. It is not FDA-approved for any medical use, and FDA advises U.S. consumers not to use unlawfully marketed tianeptine preparations.
Online or retail preparations sold as supplements are not equivalent to a regulated international prescription. Serious poisoning, dependence, withdrawal, and deaths have been reported.
How it works
Tianeptine has opioid-receptor activity and other effects on brain signaling. It should not be described as a harmless vitamin, simple serotonin booster, or risk-free alternative to opioids.
What to expect over time
A regulated depression treatment requires follow-up over weeks. Increasing use, running out early, or feeling withdrawal between doses are reasons for prompt medical assessment.
Taking your medication
- If prescribed abroad, follow the current local prescription and dispensing rules. Do not substitute an online preparation.
- Do not escalate doses, combine sources, or use it to self-treat opioid withdrawal.
- If you have been using it regularly, contact a healthcare professional promptly for help stopping; withdrawal may need treatment.
- Do not combine with alcohol, opioids, benzodiazepines, or other sedatives.
When to get help
Emergency symptoms. Call 911 for slow or stopped breathing, inability to wake, collapse, or a seizure. If opioid-reversal medicine is available, use it according to its instructions while awaiting help.
Prompt medical advice. Seek prompt care for withdrawal, escalating use, severe agitation, confusion, or persistent vomiting. Do not manage severe withdrawal alone.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, abdominal discomfort, or constipation
- Dizziness or sleepiness
- Anxiety or sleep disturbance
- Dependence, withdrawal, or dangerous respiratory effects
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Review the exact source, amount, frequency, other substances, breathing symptoms, mood, and withdrawal history honestly with your provider.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss opioid or other substance dependence, depression, liver or kidney disease, pregnancy, and breastfeeding. Unregulated preparations have additional uncertainty about contents.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Opioids, alcohol, benzodiazepines, and other sedatives can add life-threatening respiratory depression. MAOIs and other psychiatric medicines require specialist review.
Everyday tips
Keep unregulated preparations away from children and others.
Use one coordinated medical plan for depression and substance-related concerns.
Your questions answered
Is it an approved dietary supplement?
No. FDA states that tianeptine is not a lawful dietary ingredient and has no approved U.S. medical use.
What if I am already taking it daily?
Bring the container or a label photo and an honest dose history to a clinician. Treatment can address withdrawal and the symptoms you were trying to relieve.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.