Kratom and Tianeptine: Are They Safe to Use Together?
Key Takeaways: Tianeptine is a drug originally developed in France and prescribed in parts of Europe and Latin America as an antidepressant. Though marketed in the U.S. as a “nootropic” or mood enhancer, it is not FDA-approved and is often sold in gas stations and smoke shops under misleading labels. Tianeptine acts on the brain’s opioid receptors—specifically the mu-opioid receptor—giving it effects similar to opioids like morphine and making it highly addictive. Its use and misuse have grown in the U.S., often alongside substances like kratom, despite growing concerns about its safety and lack of regulation.
Recently, there has been more public attention around kratom and its potential dangers. However, there are other substances found as easily, with similar dangers. Tianeptine is just another purported “herbal supplement” found in gas stations, delis, and smoke shops. Combining these substances raises the risks associated with each.
What is Tianeptine?
Tianeptine, known as “gas station heroin,” was synthesized in the 1960s by French researchers looking to make new anti-depressants. It is classified as a tricyclic antidepressant, prescribed in many countries like Europe and Latin America for depression, anxiety and other disorders, but it is not approved in the United States. It is sold in gas stations, smoke shops, and more as a "nootropic," or a cognitive enhancer. Similarly to kratom, which is found on the same shelves and online stores as tianeptine. With both being advertised as a dietary supplement that helps with a person's mood and eases pain. Because it is not illegal, and prescribed as a psychiatric medication in some places, people believe it is a safer option. However, there is a growing trend of tianeptine misuse and addiction, in wake of all of the public attention given to kratom.
How it Works
Both of these substances are addictive and bind to the opioid receptors in the brain, with tianeptine binding more directly to the mu-opioid receptor, the same as morphine. This was only recently discovered, for a long time its mechanism of action was unknown. Like kratom, tianeptine is found in different small drink “elixirs,” powder, and pills. And, both have been found to contain other compounds, such as synthetic cannabinoids and even lead. Tianeptine has also contributed to overdose deaths. Tianepetine can be highly additive. And, a person's tolerance can increase quickly. Meaning, someone would have to take more and more of the substance to feel its effects, and eventually to just avoid withdrawal.
The Dangers of Combining Kratom and Tianeptine: Physical Risks
Tianeptine and kratom are both unregulated, there is no federal ban, while some states have imposed their own laws. As a result, potency and quality is unknown. Both can be highly addictive, and mixing them both can result in having a greater addictive potential. There is overdose risk involved with both substances. There are physical dangers that come with them. Combining kratom and tianeptine intensifies their respective sedative effects, which then increases the chances of respiratory depression, loss of consciousness, seizures, coma, and death. Mixing these substances together can also cause lowered blood pressure, increased heart rate, and cardiac arrest. But, there is some good news, narcan can reverse the effects of tianeptine overdoses.
The Dangers of Combining Kratom and Tianeptine: Psychological Risks
On top of the adverse physical reactions that can come from taking these substances together, there are psychological risks as well. Kratom itself can cause paranoia, confusion, delusions, and hallucinations. Tianeptine carries the same issues, as well as anxiety, insomnia, mood swings, impaired judgement, and even suicidal ideation. Because there is an overlap in psychiatric symptoms between them, when taken together it can amplify the negative effects. Resulting in more severe negative behaviors.
Withdrawing From Tianeptine
Like kratom, tianeptine withdrawal resembles the same symptoms as classic opioids do. While kratom and tianeptine may initially help with anxiety and depression, there may be rebound problems. Meaning, after quitting the substance anxiety and depression can worsen for a period. This sometimes contributes to relapse, as a person wants these symptoms to go away, and they feel like their only option is to go back to the substance. The side effects of the withdrawal can also lead to agitation, chills, muscle pain, sweating, nausea, and headaches. And, abdominal pain, nightmares, constipation, dizziness, and drowsiness. The withdrawal symptoms can be severe. However, these can be managed by going to an in-patient detox and residential program, where patients are supervised and helped throughout the process.
There is Hope
With treatment and time, a person can recover from kratom and tianeptine abuse. And, there are medications that have been proven to help with cessation, and abstinence later on. Beyond general psychiatric medications, including anti-depressants, there are other options. Some of these are buprenorphine, naltrexone, methadone and sublocade. These are used to treat opioid use disorder, but have been shown to help with both kratom and tianeptine abuse.