Rankings / Mood, Anxiety & Stress
Tianeptine
Mood, Anxiety & Stress · Atypical antidepressant / mu-opioid agonist
Tier C-
Bottom line
Read Off Label grades Tianeptine as C- (4.3/10) based on moderate evidence, med benefit magnitude, and a high-risk safety profile.
Sold OTC as 'ZaZa', 'Tianaa', 'Neptune's Fix' in gas stations.
Typical use: 12. — Rx in EU/Asia; unscheduled US.
What this is
Sold OTC as 'ZaZa', 'Tianaa', 'Neptune's Fix' in gas stations. CDC/FDA multiple safety alerts. Poison control calls and deaths rising steeply. Withdrawal resembles opioid withdrawal. Multiple US states (AL, FL, GA, IN, LA, KY, MI, MN, MS, NJ, OH, TN) have scheduled it. Do not use recreationally.
Mechanism
Originally classified as 'serotonin reuptake enhancer' but primary action is full mu-opioid receptor agonism at clinical doses; also glutamatergic modulation
Dose & route
12.5 mg 2-3x/day (therapeutic); abusers often ingest hundreds to thousands of mg/day
Citations
- https://pubmed.ncbi.nlm.nih.gov/25449699/
- https://www.cdc.gov/mmwr/volumes/71/wr/mm7146a1.htm
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6566157/
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Tianeptine work?
- Read Off Label rates the evidence for Tianeptine as Moderate and the benefit magnitude as med, producing an overall grade of C- (4.3/10). Sold OTC as 'ZaZa', 'Tianaa', 'Neptune's Fix' in gas stations.
- Is Tianeptine safe?
- Tianeptine has a high risk profile in published human data. Legal status: Rx in EU/Asia; unscheduled US (FDA warnings; state-level scheduling accelerating). This is not medical advice — see the disclaimer.
- What is the typical dose for Tianeptine?
- 12.5 mg 2-3x/day (therapeutic); abusers often ingest hundreds to thousands of mg/day
- How does Tianeptine work?
- Originally classified as 'serotonin reuptake enhancer' but primary action is full mu-opioid receptor agonism at clinical doses; also glutamatergic modulation
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.