If there is one thing the USA does not need, that thing is another easily available, very addictive, potentially fatal substance with an extensive list of side effects and a wicked withdrawal course, especially when that substance is not detectable by standard drug test kits used by parents, employers, and probation officers.

Tianeptine (generic name) is an atypical tricyclic antidepressant available in smoke shops and gas stations, often categorized as a dietary supplement. Although banned in several states, “zaza” is available through online sources.

In Europe and other parts of the world, the drug has long been legitimately prescribed to treat pain, anxiety, irritable bowel syndrome, depression, and even opioid use disorder. It works on the brain’s opioid receptors and releases endorphins like serotonin. A large proportion of patients who take it are in late middle age.

The acceptance for medical use may be why the supplies of product made elsewhere are safer.
In the U.S., nobody can be quite sure what they are getting. The strength of a dose might vary by many orders of magnitude, and the pills or powder might be dangerous for other reasons.

The Cleveland Clinic warns that these products are not manufactured to the highest standards:

This means they could contain lead or have other heavy metal contamination or be contaminated by microorganisms such as salmonella or mold. They could also contain other drug ingredients that are not disclosed. Knowingly or unknowingly combining active ingredients can increase the risk of adverse events.

Even when the amount of tianeptine is not life-threatening, there are apparently at least 20 possible miserable side effects, including many shared with opiate abuse. Side effects vary wildly, depending on individual factors like genetics, diet, general state of health, prior drug experiences, and the “set and setting.”

Tianeptine is said to reduce the symptoms of depression, which makes the “gas station heroin” nickname confusing, because heroin, morphine and opium itself are generally recognized as downers. Meanwhile, this stuff is apparently sold as an energy booster — thus its popularity with truckers who prefer to stay awake on long boring drives. (But, just to keep things interesting, users are warned not to drive or operate heavy machinery.)

Tianeptine is often touted as a memory improver, and as possessing the ability to keep a person awake, focused, and capable of accomplishing more, which sounds like it would be a hit with the Adderall crowd, including anxious college students.

Apparently it is manageable when taken in the doses prescribed in Europe. But Americans always go too far, and in many cases have no qualms about going far enough to invite addiction or a fatal OD. As might be expected, Vice.com has published the harrowing story (by Manisha Krishnan) of a Florida couple who went through bottles of zaza pills on a daily basis.

The narrative includes detailed descriptions of the effects of both taking the stuff, and not taking it when they had no money, or their local store’s supply had run out. According to those who know, coming off tianeptine is a stone bummer. Experienced junkies have said it’s worse than kicking heroin or fentanyl. Yet another source says withdrawal only lasts a week which, all things considered, sounds unlikely.

In the United States it is often sold as part of the nootropic genre of substances, which implies mood enhancement and improved cognitive function. Journalist Bill Chappell mentions that its half-life inside the body promises quick clearance, which encourages “the temptation is to do it often.”

There is a lot of mystery around which brain receptors tianeptine relates to, and how the relationship works. Either this chemical doesn’t follow the rules, or perhaps the rules are not yet thoroughly mapped.

Todd Hillhouse, a University of Wisconsin associate professor and expert on antidepressants, told NPR that awareness of tianeptine has been like “having a key that fits a lock — but not knowing which lock the key opens.” Other researchers have described the drug as promoting neuroplasticity, with apparently a “neurorestorative” ability to correct brain damage.

For this and other reasons, legit scientists are trying to create a version of it without the negative effects. Meanwhile, clinical trials are underway seeking to prove the efficacy of the drug in treating pain, depression, PTSD, and other conditions.

Written by Pat Hartman. First published September 13, 2024.

Sources:

“What is Zaza? Exploring the Side Effects & Risks of Tianeptine,” FirstStepbh.com, March 19, 2024.

“Know the Dangers of ‘Gas Station Heroin’,” ClevelandClinic.org, February 2, 2024.

“The Rise of ‘Gas Station Heroin’,” Vice.com, April 18, 2023.

“8 things to know about the drug known as ‘gas station heroin’,” NPR.org, July 14, 2024.

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