Rankings / Cognitive — Nootropics
Tianeptine
Cognitive · Atypical antidepressant / mu-opioid agonist
Tier C
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/
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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.