Private, confidential help is available

Call Now

Tianeptine Withdrawal: Symptoms, Timeline, and How to Stop Safely

What tianeptine ("gas station heroin") withdrawal feels like, how long it lasts, and how to stop safely.
  • Fact checked
  • Medically Reviewed
Sedona, AZ

Table of Contents

Prefer to speak with someone?

Admissions can answer your questions privately.

Call admissions

1 (888) 907-7075

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Tianeptine withdrawal at a glance

After daily tianeptine use, don’t quit or cut back on your own without medical advice. If someone is hard to wake, breathing slowly, or has a seizure, call 911.

What it is
An antidepressant used in some other countries, sold in the US as “gas station heroin” under names like Zaza, Tianaa, and Neptune’s Fix
How it acts
On the same mu-opioid receptors as morphine and other opioids
Common symptoms
Agitation, anxiety, nausea, vomiting, diarrhea, sweating, aches, insomnia, cravings
When it starts
Often within hours of the last dose, because tianeptine wears off quickly
How long
No study has defined it; low mood, anxiety, and cravings can linger
Safest approach
A plan made with a qualified clinician, not a do-it-yourself taper
Legal status
As of October 2026, not FDA-approved and not yet federally controlled; the DEA has proposed Schedule I, and at least 15 states restrict it
At ATMC
Residential addiction care in Sedona, Arizona, with medically supervised detox
Withdrawal symptomsTimelineStopping safelyGet help
Table of contents (12)

What is tianeptine withdrawal?

Tianeptine withdrawal is the set of opioid-like symptoms that can start when someone who uses tianeptine regularly stops or sharply cuts back. Common symptoms include agitation, anxiety, nausea, vomiting, diarrhea, sweating, muscle aches, trouble sleeping, and strong cravings.2,8,9

It happens because tianeptine activates the brain’s mu-opioid receptors, the same targets as morphine and other opioids.13,14 The FDA warns that stopping tianeptine suddenly can cause opioid-like withdrawal.2 Withdrawal is a common reason people end up in the emergency room: in one poison center study, 65% of tianeptine cases involved withdrawal, and about a third of all cases went to intensive care.12

Withdrawal is a sign of physical dependence, not a personal failing. It is treatable, and you don’t have to go through it alone.

Looking for help? See how our residential addiction treatment program in Sedona works, or call (888) 907-7075.

Phenibut withdrawal can be dangerous. See our phenibut withdrawal guide.

What is tianeptine?

Short answer: tianeptine is an antidepressant approved in some European, Asian, and Latin American countries. It has never been approved for any medical use in the United States.1,4,7

In the US, tianeptine is sold in gas stations, convenience stores, vape shops, and online as a “nootropic,” “research chemical,” or dietary supplement. Brand names include Tianaa, Zaza, Neptune’s Fix, Pegasus, and TD Red, and it is often called “gas station heroin.”2,3 According to the FDA, US case reports describe people taking 1.3 to 250 times the dose used in countries where it is prescribed.2

Tianeptine leaves the body quickly. Its half-life is about 2.5 hours, so the effect fades fast and people often redose through the day.7,15 That pattern makes dependence more likely.

Is tianeptine an opioid?

In how it acts on the body, yes. Lab studies show tianeptine activates the mu-opioid receptor, and its mood effects in animals depend on that receptor.5,13,14 People with a history of opioid use disorder may be at particular risk of misusing it.1 Some people find tianeptine online while looking for a way to self-treat opioid addiction, then become dependent on it.24

Is tianeptine legal?

As of October 2026, tianeptine is not controlled under federal drug law, but it is not legal to sell as a supplement.8 The FDA says tianeptine is not a dietary ingredient and is an unsafe food additive, so supplements containing it are adulterated.4 The FDA has also placed tianeptine products on import alert.2,6

On July 8, 2026, the Drug Enforcement Administration (DEA) proposed placing tianeptine in Schedule I. The public comment period closed August 7, 2026, and no final rule had been published when this article was written.7 The DEA notice lists 15 states that already control or ban tianeptine, including Alabama, Florida, Georgia, Michigan, Ohio, Tennessee, and Virginia. Arizona was not on that list.7 State and federal rules are changing, so check the current law where you live.

If a ban suddenly cuts off supply, people who use tianeptine daily may go into withdrawal without planning to. That is one more reason to talk with a clinician now.

What happened with Neptune’s Fix?

In 2023 and 2024, the FDA warned about Neptune’s Fix products after reports of seizures, loss of consciousness, and deaths, and the products were recalled.3 Testing found synthetic cannabinoids in some of them. In a New Jersey cluster, most patients were admitted to intensive care and several needed a breathing tube.10,11 This is a reminder that the label on a tianeptine product may not tell you what is inside.

Tianeptine withdrawal symptoms

Short answer: tianeptine withdrawal looks a lot like opioid withdrawal. How strong it is depends on how much you used, how often, for how long, and whether you use other substances too.7,12

Physical symptoms can include:

  • Stomach: nausea, vomiting, and diarrhea7,9
  • Body: muscle aches, chills, sweating, and tremor7,9
  • Heart: fast heart rate and high blood pressure9
  • Nose and sleep: runny nose and insomnia7

Emotional and mental symptoms can include:

  • Agitation and anxiety, the most common complaints in poison center reports9,12
  • Mood swings and irritability7
  • Strong cravings7
  • Depression or anxiety returning, especially if tianeptine was first used for mood23

Some people have a harder course. Published cases describe severe withdrawal that needed hospital care, including confusion in people who were also using other substances.16,25 Babies born to mothers who used tianeptine during pregnancy have shown opioid withdrawal after birth.28

Standard urine drug screens don’t detect tianeptine, so tell any doctor treating you that you have used it.9,16

Know the limits of the evidence. What we know comes from poison center data, case reports, and online user reports. No controlled studies have looked at tianeptine withdrawal.17

Struggling to stop tianeptine? Talk to our team about medically supervised detox and what a residential stay looks like.

Call (888) 907-7075Free, confidential consultation

Verify your insurance →How we help with addiction →

Tianeptine withdrawal timeline

Short answer: symptoms often start within hours of the last dose. No study has mapped how long tianeptine withdrawal lasts, so the timeline below combines tianeptine case reports with what is known about withdrawal from short-acting opioids.

Time since last dose What may happen What we know
First hours to 1 day Anxiety, restlessness, sweating, yawning, runny nose, cravings Tianeptine wears off fast; one patient redosed every 4 to 6 hours to avoid withdrawal.7 In one case report, symptoms began about 12 hours after the last dose.29
Days 2 to 3 Symptoms may peak: aches, chills, nausea, vomiting, diarrhea, agitation Short-acting opioid withdrawal usually peaks at 36 to 72 hours.18 Tianeptine-specific data on the peak are limited.
Days 4 to 7 Physical symptoms slowly ease; tiredness and poor sleep often remain Short-acting opioid withdrawal usually fades over 4 to 7 days after the peak.18 In one hospitalized patient, symptoms improved within 3 days on treatment.25
Weeks to months Low mood, anxiety, poor sleep, cravings Protracted withdrawal after opioids can last weeks or months.20 Depression may return if it was there before.23

Your own timeline can be shorter or longer. In user reports, higher doses were linked to withdrawal.21 Many people also use phenibut, alcohol, benzodiazepines, or opioids, which makes withdrawal more complicated to treat.9

Is it safe to quit tianeptine cold turkey?

Short answer: not on your own after regular, heavy use. Many people in poison center reports needed hospital or intensive care.11,12

The risks are real:

  • Severe withdrawal. Agitation, vomiting, and a racing heart can become hard to manage at home.9,12
  • Dehydration. Ongoing vomiting and diarrhea can cause dehydration and mineral imbalances.19
  • Overdose after a break. Withdrawal lowers tolerance. Going back to a usual amount, or switching to other opioids, can cause an overdose.19
  • Mixed-drug deaths. In Tennessee, all six tianeptine-involved overdose deaths from 2021 to 2023 also involved other drugs.27
  • Mental health crises. Depression and anxiety can surface or return during withdrawal.23

Using kratom or 7-OH too? These also act on opioid receptors. Learn what 7-OH withdrawal looks like.

Read about 7-OH withdrawal

How to stop tianeptine safely

Short answer: make the plan with a qualified clinician, such as an addiction medicine doctor or a supervised treatment program. There is no standard tianeptine taper protocol, so a plan built around your health and use history matters more than any schedule you find online.17

Why a do-it-yourself taper is so hard:

  • It wears off fast. A short half-life drives frequent redosing, which makes steady reductions difficult.7,15
  • You may not know what you’re taking. Products have been mislabeled or contaminated.3,10
  • Supply can change overnight. A new state or federal ban can force an unplanned stop.7
  • Cravings are strong. Without support, many people end up using more, not less.

What a clinician may do:

  • Assess first. Your use, other substances, physical health, and mental health shape the plan.
  • Consider medication. Doctors have used buprenorphine (with naloxone, as in Suboxone) and, when that wasn’t enough, methadone to treat tianeptine dependence.23,24,26 In a 2026 review of published cases, buprenorphine was the most common long-term treatment.17 Whether to stay on these medicines or taper off is a decision for you and your prescriber.
  • Treat symptoms. In poison center cases, withdrawal was treated with medicines for agitation and nausea, plus fluids.9
  • Plan for after. Detox is a start, not the whole treatment. Depression or anxiety that led to tianeptine use needs care too.

Buprenorphine has to be started carefully, and doctors choose different starting methods for different people, so it should only be started under a prescriber’s guidance.24 Please don’t try to work out doses or timing on your own.

Helping a loved one through tianeptine withdrawal

Many people start tianeptine thinking it is a legal supplement for mood or focus. Families are often the first to notice the change.

  • Learn the signs. Frequent dosing, money going to gas stations or smoke shops, and flu-like sickness when they run out can point to dependence.
  • Keep naloxone at home. Naloxone has reversed tianeptine overdoses.7,9 Call 911 if someone is extremely drowsy, can’t be woken, or is breathing slowly.
  • Take talk of suicide seriously. Call or text 988 any time, or 911 in an emergency.31
  • Stay calm and specific. Talk about what you have seen and that you are worried, not about blame.
  • Help them get assessed. Offer to make the first call with them or to drive them to an appointment.

Family members are welcome to call. Our admissions team can answer your questions about a loved one’s situation, confidentially, at (888) 907-7075.

Quitting tianeptine at home vs. at ATMC

At home At ATMC
Withdrawal Managed largely on your own Monitored by medical and nursing staff
Support Scheduled appointments, if any Staff available 24/7
Triggers The same stores, stress, and routines A calm residence in Sedona, away from daily triggers
Root causes Rarely tested Lab testing on arrival, nutrition, and holistic detox
Therapy Usually an hour a week Individual, group, and holistic therapies daily
Depression and anxiety Often treated separately, or not at all Dual diagnosis care treats both together
See where you’d stayTour our Sedona residence →Hear from clientsReal recovery stories →

When to get help right away

  • Call 911 if someone is extremely sleepy, can’t be woken, has a seizure, or is breathing slowly or not at all. Give naloxone if you have it.2,9
  • Call Poison Help at 1-800-222-1222 with questions about a tianeptine exposure.30
  • Call or text 988 for the Suicide and Crisis Lifeline, free and open 24/7.31
  • Call the SAMHSA National Helpline at 1-800-662-4357 for confidential treatment referrals at no cost, 24/7.32

Get help with tianeptine dependence

Alternative to Meds Center is a residential treatment center in Sedona, Arizona, with about 20 years of holistic residential care. We treat opioid and other substance dependence, including prescription pain medications and heroin. Because tianeptine acts like an opioid, we approach tianeptine dependence with the same medical caution we bring to any opioid-type dependence.

Detox at ATMC happens under the observation of trained medical staff, who watch your vital signs and overall health. If acute withdrawal needs hospital-level care first, we refer you to an acute care facility, then help you transition into our program.

Every resident gets lab testing and a medical assessment on arrival. From there, your plan may include holistic detox, neurotransmitter repair with an individualized supplement plan, whole-food nutrition, individual and group counseling, and peer support. If depression or anxiety is part of the picture, our dual diagnosis program treats both at the same time.

Our Medical Director describes how the team watches over each client:

“Our medical and nursing teams collaborate closely to monitor each client’s tapering plan, assess progress, and make adjustments as clinically indicated. The team regularly evaluates symptoms, sleep patterns, mood, and overall well-being to support a safe and individualized process.”
Kimberli Galloway, PMHNP-BC, Medical Director

Learn more about our addiction treatment program, opioid dependence and withdrawal, opiate withdrawal, and antidepressant dependence.

Talk to our admissions team. Ask about detox for tianeptine, what a stay looks like, and insurance. Family members are welcome to call.

Call (888) 907-7075Free, confidential consultation

Prefer to write? Contact admissions online →

Tianeptine withdrawal FAQs

How long does tianeptine withdrawal last?
No study has defined it. Based on what is known about short-acting opioids, the worst physical symptoms often peak around days 2 and 3 and ease over about a week.18 Low mood, anxiety, poor sleep, and cravings can last weeks or months.20 Heavy or mixed use can make it longer.
Is tianeptine withdrawal dangerous?
It can be. In one poison center study, more than half of tianeptine cases were admitted to the hospital and about a third went to intensive care.12 Vomiting can cause dehydration, and lower tolerance after withdrawal raises overdose risk if someone uses again.19 Medical supervision is safer.
Does Suboxone help tianeptine withdrawal?
Buprenorphine-naloxone, the medicine in Suboxone, has been used to treat tianeptine dependence in published cases.23,24 When it wasn’t enough, doctors have used methadone.26 These medicines must be started and managed by a prescriber.
Is tianeptine an opioid?
It is sold as an antidepressant abroad, but it activates mu-opioid receptors like morphine does.13,14 That is why it can cause opioid-like dependence, withdrawal, and overdose.2
Is tianeptine legal in the US?
It is not FDA-approved and is not lawful in supplements.1,4 As of October 2026 it is not federally controlled, but the DEA proposed placing it in Schedule I in July 2026, and at least 15 states already control or ban it.7 Check your state’s current law.
Does tianeptine show up on a drug test?
Not on standard urine drug screens. Specialty lab tests can detect it.9 If you are being treated for withdrawal or an overdose, tell the care team you have used tianeptine.
Can you overdose on tianeptine?
Yes. Tianeptine can cause slowed breathing, coma, and death, and naloxone has reversed tianeptine overdoses.2,9 Risk is higher when it is mixed with other drugs.27 If someone is hard to wake or breathing slowly, call 911.
How do I know if I’m dependent on tianeptine?
Signs include needing more for the same effect, dosing every few hours, feeling sick, anxious, or achy when you go without, and finding it hard to cut back. Many users report that tolerance builds quickly.22 A clinician can help you sort out what is going on.

Sources:

1. U.S. Food and Drug Administration. Tianeptine Products Linked to Serious Harm, Overdoses, Death. Content current as of May 9, 2025. [cited 2026 Oct 20]

2. U.S. Food and Drug Administration. New “Gas Station Heroin” Tianeptine Product Trend. Dear Colleague letter, May 8, 2025. [cited 2026 Oct 20]

3. U.S. Food and Drug Administration. FDA warns consumers not to purchase or use any tianeptine product due to serious risks. Updated May 8, 2025. [cited 2026 Oct 20]

4. U.S. Food and Drug Administration. Tianeptine in Dietary Supplements. Content current as of February 22, 2023. [cited 2026 Oct 20]

5. Edinoff AN, Sall S, Beckman SP, Koepnick AD, Gold LC, Jackson ED, et al. Tianeptine, an Antidepressant with Opioid Agonist Effects: Pharmacology and Abuse Potential, a Narrative Review. Pain Ther. 2023;12(5):1121-1134. doi:10.1007/s40122-023-00539-5. PMID: 37453966. [cited 2026 Oct 20]

6. U.S. Food and Drug Administration. Import Alert 66-66. Published October 22, 2024. [cited 2026 Oct 20]

7. Drug Enforcement Administration. Schedules of Controlled Substances: Placement of Tianeptine in Schedule I. Proposed rule. Federal Register. 2026;91 FR 42150. July 8, 2026. [cited 2026 Oct 20]

8. Drug Enforcement Administration, Diversion Control Division. Tianeptine. Drug and Chemical Evaluation Section, May 2026. [cited 2026 Oct 20]

9. El Zahran T, Schier J, Glidden E, Kieszak S, Law R, Bottei E, et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System, United States, 2000-2017. MMWR Morb Mortal Wkly Rep. 2018;67(30):815-818. doi:10.15585/mmwr.mm6730a2. PMID: 30070980. [cited 2026 Oct 20]

10. Counts CJ, Spadaro AV, Cerbini TA, Krotulski AJ, Greller HA, Nelson LS, et al. Notes from the Field: Cluster of Severe Illness from Neptune’s Fix Tianeptine Linked to Synthetic Cannabinoids, New Jersey, June-November 2023. MMWR Morb Mortal Wkly Rep. 2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5. PMID: 38300852. [cited 2026 Oct 20]

11. Quadir M, Rine NI, Badeti J, Hays HL, Michaels NL, Yang J, et al. Tianeptine Exposures Reported to United States Poison Centers, 2015-2023. J Med Toxicol. 2025;21(1):30-41. doi:10.1007/s13181-024-01053-6. PMID: 39724478. [cited 2026 Oct 20]

12. Rushton W, Whitworth B, Brown J, Kurz M, Rivera J. Characteristics of tianeptine effects reported to a poison control center: a growing threat to public health. Clin Toxicol (Phila). 2021;59(2):152-157. doi:10.1080/15563650.2020.1781151. PMID: 32552075. [cited 2026 Oct 20]

13. Gassaway MM, Rives ML, Kruegel AC, Javitch JA, Sames D. The atypical antidepressant and neurorestorative agent tianeptine is a μ-opioid receptor agonist. Transl Psychiatry. 2014;4(7):e411. doi:10.1038/tp.2014.30. PMID: 25026323. [cited 2026 Oct 20]

14. Samuels BA, Nautiyal KM, Kruegel AC, Levinstein MR, Magalong VM, Gassaway MM, et al. The Behavioral Effects of the Antidepressant Tianeptine Require the Mu-Opioid Receptor. Neuropsychopharmacology. 2017;42(10):2052-2063. doi:10.1038/npp.2017.60. PMID: 28303899. [cited 2026 Oct 20]

15. Royer RJ, Albin H, Barrucand D, Salvadori-Failler C, Kamoun A. Pharmacokinetic and metabolic parameters of tianeptine in healthy volunteers and in populations with risk factors. Clin Neuropharmacol. 1988;11 Suppl 2:S90-96. PMID: 3180120. [cited 2026 Oct 20]

16. Lauhan R, Hsu A, Alam A, Beizai K. Tianeptine Abuse and Dependence: Case Report and Literature Review. Psychosomatics. 2018;59(6):547-553. doi:10.1016/j.psym.2018.07.006. PMID: 30149933. [cited 2026 Oct 20]

17. Anand A, Alessi MR, Toussi RA, Tian J, Raffoul JJ, Pratt N, et al. Tianeptine misuse and addiction: A systematic review of withdrawal, toxicity, and clinical management. Drug Alcohol Depend. 2026;285:113196. doi:10.1016/j.drugalcdep.2026.113196. PMID: 42177839. [cited 2026 Oct 20]

18. Kosten TR, Baxter LE. Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. Am J Addict. 2019;28(2):55-62. doi:10.1111/ajad.12862. PMID: 30701615. [cited 2026 Oct 20]

19. MedlinePlus, National Library of Medicine. Opiate and opioid withdrawal. [cited 2026 Oct 20]

20. Substance Abuse and Mental Health Services Administration. Protracted Withdrawal. Substance Abuse Treatment Advisory, Volume 9, Issue 1, July 2010. HHS Publication No. (SMA) 10-4554. [cited 2026 Oct 20]

21. Smith KE, Rogers JM, Strickland JC, Epstein DH. When an obscurity becomes trend: social-media descriptions of tianeptine use and associated atypical drug use. Am J Drug Alcohol Abuse. 2021;47(4):455-466. doi:10.1080/00952990.2021.1904408. PMID: 33909525. [cited 2026 Oct 20]

22. Smith KE, Hill K, Bergeria CL, Strickland JC. Tianeptine Products: Public Health Threat or Niche Substance use? J Psychoactive Drugs. 2025. doi:10.1080/02791072.2025.2570939. PMID: 41084181. [cited 2026 Oct 20]

23. Trowbridge P, Walley AY. Use of Buprenorphine-Naloxone in the Treatment of Tianeptine Use Disorder. J Addict Med. 2019;13(4):331-333. doi:10.1097/ADM.0000000000000490. PMID: 30550394. [cited 2026 Oct 20]

24. Szczesniak L, Sullivan R. Microdose Induction of Buprenorphine in a Patient Using Tianeptine. J Addict Med. 2022;16(6):736-738. doi:10.1097/ADM.0000000000001003. PMID: 35709488. [cited 2026 Oct 20]

25. Rawal VY, Gallardo M, Henderson K, Hall OT, Klisovic N, Sikic-Klisovic E. Severe tianeptine withdrawal symptoms managed with medications for opioid use disorder: a case report. J Addict Dis. 2025;43(1):98-103. doi:10.1080/10550887.2023.2290139. PMID: 38095574. [cited 2026 Oct 20]

26. Coyle DT, Kitano M, Calcaterra S. When Buprenorphine Was Not Enough: Methadone Treatment of Tianeptine Use Disorder. J Addict Med. 2026. doi:10.1097/ADM.0000000000001782. PMID: 42767626. [cited 2026 Oct 20]

27. Hershey HL, Onyango EM, Durst K, Korona-Bailey J, Mukhopadhyay S. Tianeptine-involved emergency department visits, fatal overdoses, and substance seizures in Tennessee, 2021-2023. Drug Alcohol Depend Rep. 2024;12:100272. doi:10.1016/j.dadr.2024.100272. PMID: 39258110. [cited 2026 Oct 20]

28. Ikeri K, Anderson A, Eyal F, Whitehurst R. Neonatal Opioid Withdrawal Syndrome Following Prenatal Use of Supplements Containing Tianeptine. Pediatrics. 2024;153(2):e2023062382. doi:10.1542/peds.2023-062382. PMID: 38213293. [cited 2026 Oct 20]

29. Farsani A, Reyes C. Tianeptine’s Obscured Withdrawal, Presentation, and Treatment. Cureus. 2024;16(6):e62554. doi:10.7759/cureus.62554. PMID: 39022455. [cited 2026 Oct 20]

30. Health Resources and Services Administration. Poison Help. [cited 2026 Oct 20]

31. 988 Suicide and Crisis Lifeline. 988lifeline.org. [cited 2026 Oct 20]

32. Substance Abuse and Mental Health Services Administration. SAMHSA’s National Helpline. [cited 2026 Oct 20]


This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

Social Profile: LinkedIn

View Bio

Medical disclaimer

This article is for educational purposes only and does not provide medical advice, diagnosis, or treatment. Never start, stop, or change a prescription medication without consulting a qualified healthcare professional who understands your medical history. If you are experiencing an immediate medical or safety emergency, call 911.