thoughtscape NP Psychiatry · Patient education
Tianeptine
Stablon / international prescription reference
Not FDA approved. Tianeptine can cause dependence and fatal poisoning. If already using it, seek medical help.
Draft for review · Clinical content has not been revalidated for this website.
Safety information, not a recommendation to start tianeptine or a dosing guide for unregulated products
What it is used for
In France, regulated Stablon tablets are prescribed for depression. That approval does not make products sold in U.S. stores or online safe.
The FDA advises against purchasing or using tianeptine products. Claims about treating pain, anxiety, or opioid addiction are not U.S. approvals.
How it works
Activates mu-opioid receptors. This action matters because tianeptine can cause dependence, slowed breathing, and potentially fatal overdose.
It is not an SSRI. Animal findings and proposed effects on glutamate signaling do not establish a complete human antidepressant mechanism.
What to expect over time
IF ALREADY USING
Tell a clinician the exact product, amount, and frequency. Bring the label or a photo. Do not hide use because of embarrassment.
DURING TREATMENT
For legitimate prescribed treatment abroad, benefit takes time. Worsening mood, side effects, or taking more than planned need prompt review.
WHEN STOPPING
Withdrawal may include cravings, sweating, aches, diarrhea, and insomnia. Get a supervised plan; severe symptoms need urgent care.
Taking your medication
Do not buy tianeptine online or from convenience stores. A supplement or research-chemical label does not establish safety, purity, or dose.
If prescribed a regulated product abroad, follow that clinician's instructions. Do not increase the dose or substitute an unregulated product.
Do not convert foreign tablet instructions to powders or concentrated liquids. If already dependent, seek medical help rather than self-treating withdrawal.
When to get help
Call 911 for slow or difficult breathing, inability to awaken, collapse, or a seizure. Suspected overdose needs immediate help, not sleep or observation alone.
Naloxone may help opioid-type breathing suppression, but emergency care is still needed. Discuss access and how to use it with a clinician or pharmacist.
Report suicidal thoughts, severe withdrawal, confusion, yellow skin/eyes, or dark urine promptly. Immediate self-harm danger requires emergency help.
Early side effects
Nausea, constipation, stomach discomfort, dry mouth, dizziness, headache, sleepiness, or insomnia can occur with prescribed treatment.
Other effects to discuss
Taking extra doses, craving, or feeling ill between doses needs attention. Serious risks include liver injury, low sodium, seizures, and overdose.
What to keep track of
Review mood, sleep, functioning, sedation, and the actual amount being taken. Ask directly about cravings, extra doses, and other substances. Routine urine drug screens may miss tianeptine; a negative result does not rule out exposure or poisoning. Testing depends on symptoms and medical risks.
Before you start
Discuss bipolar symptoms, self-harm risk, alcohol, or opioid use, previous dependence, kidney or liver disease, low sodium, frailty, pregnancy and nursing. The French product is not routine treatment for anyone under 18 and is contraindicated under 15. Tell the pharmacist about allergies and inherited sugar-intolerance disorders.
Medicines & interactions
Alcohol / sedatives
Avoid alcohol. Combining tianeptine with opioids, sleeping pills, or other sedatives raises concern for dangerous sleepiness and slowed breathing.
MAOI antidepressants
Do not combine. A planned washout is required when switching; the interval depends on direction and the other medicine. Have the prescriber confirm dates.
All other products
Review prescriptions, OTC medicines, and supplements. A limited liver-enzyme interaction profile does not mean combinations are safe.
Surgery / anesthesia
Tell the anesthesia team about use well before surgery. They must coordinate any interruption; do not stop or postpone urgent care on your own.
Unregulated products
Contents may differ from the label or include other harmful drugs. Do not assume similar brand names, packaging, or claimed strengths mean equivalent products.
Everyday tips
You deserve help without judgment. Tell the care team when you last took it, how often you use it, and whether you combine it with alcohol or other drugs.
Ask about evidence-based options for depression, anxiety, pain, or substance-use problems. Tianeptine marketed online is not a safe substitute for care.
Have someone you trust watch for worsening mood or unusual behavior. Young adults under 25 need particular attention, but monitoring matters at every age.
Do not drive if sleepy or dizzy. Keep products away from children and pets. Never share a prescription or leave loose tablets or powders accessible.
Your questions, answered
I missed a prescribed dose. Now what?
Ask your pharmacist for instructions for the exact prescription product. Do not take extra to compensate or improvise with a powder or supplement.
Can I use a short taper?
The French prescription label describes 7-14 days, but that is not a high-dose dependence plan. Longer use or withdrawal may need a different supervised approach.
What about pregnancy or nursing?
Promptly discuss exposure or plans for pregnancy. French guidance prefers avoiding use in pregnancy and advises against breastfeeding during treatment. Do not manage dependence alone.
Does naloxone make use safe?
No. It cannot reliably address every ingredient or complication. Call emergency services for suspected overdose, even if breathing improves after naloxone.
Storage & safety
Keep any prescription in its original packaging and follow its storage label. Ask a pharmacist about safe disposal. In the U.S., call Poison Help at 1-800-222-1222 for suspected poisoning; call 911 for breathing trouble, collapse, seizure, or immediate danger. Keep the package for the treating team.
About this information
For general information only; not a substitute for individualized medical advice. This sheet does not cover every risk or interaction. Ask your prescriber or pharmacist before changing how you take this medication.
Sources
- https://www.fda.gov/drugs/drug-alerts-and-statements/fda-warns-consumers-not-purchase-or-use-any-tianeptine-product-due-serious-risks
- https://www.fda.gov/consumers/health-fraud-scams/new-gas-station-heroin-tianeptine-product-trend
- https://base-donnees-publique.medicaments.gouv.fr/medicament/65411280/extrait
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.