Tianeptine

Other names Tianeptine Sodium, Tianeptine Sulfate, Stablon

Tianeptine is a drug that has been studied in humans for its potential anti-depressant effects. Recently it has been gaining popularity among healthy self-experimenters who are trying to feel and perform better. Some people say it improves their energy levels, focus, and mood. But is it actually effective? And is it safe? Read on to find out what the science says.

This nootropic has no healthy human placebo-controlled studies that meet our inclusion criteria. Negative side effects can occur if used carelessly, so make sure you’re aware of the risks of Tianeptine.

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Benefits

Read about the effects of Tianeptine in relation to the amount of evidence we've found

Tianeptine for cognitive enhancement

In animal studies, Tianeptine has been found both effective and ineffective in enhancing cognitive functions. [2][3][4][5][6] Interestingly, it improved social behavior in monkeys. [7]

Animal studies are a weak source of evidence on which to base nootropic use decisions. So let's look at some better evidence that exists on the effects of Tianeptine on cognitive performance.

In one study, healthy people were randomized to receive a single dose of tianeptine (12.5 mg) or placebo. [8] The results were:

"Tianeptine-treated subjects were less accurate at identifying facial expressions, though this was not valence specific. The tianeptine group also showed reduced positive affective memory and reduced attentional vigilance to positive stimuli. There were no effects on emotional categorization or non-emotional cognition."

This study is the only one that has examined the cognitive effects of Tianeptine in healthy humans, and the dose used was relatively small. The actual effects of Tianeptine in healthy humans looking to enhance cognitive performance with the drug is essentially unknown to science.

In another study, 164 patients with major depressive disorder were randomized into two groups. One group received 37.5mg Tianeptine daily and the other group received Escitalopram. Both groups had significant improvements in subjective cognitive impairment of memory and attention after 12 weeks. [9] After 12 weeks, patients in the Tianeptine group had improved verbal short term memory and reduced impulsivity when compared with Escitalopram, and improved long term memory, reasoning ability, and general cognitive functioning when compared with their own baseline. The improvement seen after 12 weeks compared with the participants' own baseline may have been due to the placebo effect and the improvements seen after 12 weeks when compared with the Escitalopram group may have been due to the lack of efficacy (or even negative effects) of Escitalopram on impulsivity and verbal short term memory.

Another study also examined the cognitive effects of Tianeptine in people with depression. [11] It was found that it improved short term memory and learning processes as well as reaction time and attention. However, there was no placebo control group in this study so a strong placebo effect cannot be ruled out.

The preliminary evidence that does exist suggests that small doses of Tianeptine doesn't enhance cognitive performance in healthy humans, but that larger doses may. However, these potential benefits are only backed by evidence from people with mood disorders. No evidence in healthy humans suggests Tianeptine is an effective cognitive enhancer.

Tianeptine for mood enhancement

Based on 18 studies that examined the effects of Tianeptine compared with the effects of other proven anti-depressants in people with depression, Tianeptine is as effective as these other proven anti-depressants. [14]

Several scientific review articles have concluded it is an effective anti-depressant. [15] [16]

One study examined the effects of large doses of Tianeptine in healthy humans and found it as effective as Methylphenidate for improving mood. Methylphenidate is not used primarily for improving mood, but focus.

No placebo-controlled studies have examined the effects of Tianeptine for mood enhancement in healthy humans. It is an effective anti-depressant for people with depression, but it isn't known whether it might enhance mood in people without mood disorders.

Risks

The legality and side effects of Tianeptine

You should always consider the risks of a nootropic before you use it.

Negative side effects of Tianeptine

"Severe adverse health effects, including respiratory depression, severe sedation, and death, have occurred from the misuse of tianeptine. [...] Severe withdrawal symptoms in humans resulting in hospitalization following the use of tianeptine have been reported. Published case reports have provided evidence of adverse respiratory, neurological, cardiovascular, gastrointestinal, and withdrawal effects associated with the use of tianeptine." [19]

The Centers for Disease Control and Prevention (CDC) in the United States had a total of 11 tianeptine-related calls during the first 14 years (2000-2013) of a study they conducted, and 207 calls were reported 2014-2017. [20] This suggests a rapid increase in the use and abuse of Tianeptine.

Is Tianeptine addictive and does it lead to any withdrawal symptoms?

In one study 24 people who abused Tianeptine volunteered. They used huge doses (10-50x normal) of Tianeptine daily and also had a history of consumption of opiates. It is not defined in this study whether participants gradually decreased the dose from the average 500mg dose, which is probably what they did, or if they quit cold turkey. When these people stopped using the drug, withdrawal symptoms included large increases in anxiety and depression. [21]

Tianeptine can definitely be very addictive and lead to horrible withdrawal problems. But the same goes for Caffeine, and billions of people use it safely every day.

So are there any risks for addictive side effects in the dose-range in which it is usually consumed by healthy people looking to enhance their cognitive performance and mood?

The National Narcotics and Psychotropics Committee in France estimated that Tianeptine use resulted in 1 case of abuse and dependence per 1000 patients treated. The vast majority of the patients were treated with less than 50mg of Tianeptine. [14] The risk of abuse and dependence is higher if the user has a history of drug dependence or is young. [23]

It should be noted that this evidence, which is of high quality, consists of data on the safety of Tianeptine in people who used it under medical supervision. The risk for addiction may be higher if you do not consult a medical professional before use of the drug.

Interesting fact: Tianeptine use increased binge drinking in adolescent mice but decreased binge drinking in adult mice [25]

Tianeptine can definitely be addictive and lead to withdrawal symptoms if abused. The risk of becoming addicted to Tianeptine when used in appropriate doses appears to be extremely low but is significant if the user has a history of drug abuse.

Can Tianeptine cause liver injury?

The authors of one scientific review of the risks of various anti-depressants to cause liver injury concluded that Tianeptine is among the ones that people should be extra cautious with. If you have a pre-existing liver injury, talk with your trusted medical professional about the risks of Tianeptine before you may choose to use it.

However, this review also reported that Tianeptine didn't lead to any drug-induced liver injury and didn't affect liver function tests. [26]

Three case reports of Tianeptine-induced liver toxicity have been published. [27] It appears that prolonged daily use in high doses increases the risk of negative effects on liver functioning. Discontinuation of tianeptine led to complete recovery in at least one of these case studies (the other two are unavailable online and only referenced in another study). [28]

Tianeptine can likely cause liver injury in rare instances. It is unclear how rare liver injury is, but it is definitely highly dependent on dose and duration of use.

Effects on emotional processing

In one study, healthy people were randomized to receive a single dose of Tianeptine (12.5 mg) or placebo. [8] The results were:

"Tianeptine-treated subjects were less accurate at identifying facial expressions, though this was not valence specific. The tianeptine group also showed reduced positive affective memory and reduced attentional vigilance to positive stimuli. There were no effects on emotional categorization or non-emotional cognition."

This study is the only one that has examined the effects of Tianeptine on emotional processing in healthy humans, and the dose used was relatively small. More research on the effects of Tianeptine on emotional processing is needed.

Other negative side effects

"Since STABLON was marketed in 1989, the most commonly reported serious adverse effects in spontaneous notifications have been hepatobiliary (increased transaminases, hepatitis), neurological (seizures, drowsiness, tremor, involuntary movements, extrapyramidal symptoms), psychiatric (confusion, hallucinations), cutaneous (erythema, bullous eruptions), haematological (thrombocytopenia, agranulocytosis), cardiac (hypotension, tachycardia) and metabolic (hyponatraemia) effects. The re-assessment of tianeptine pharmacovigilance data in 2012 led to several adverse effects being added to the SPC: hyponatraemia, increased liver enzymes, hepatitis, that can, in exceptional cases, be severe, extrapyramidal symptoms and involuntary movements, confusion, hallucinations and exceptional bullous reactions." [24]

Exactly how frequent these negative side effects are is not known, but they are all very rare. Tianeptine is generally well tolerated when used in appropriate doses. [30]

All of the negative side effects of Tianeptine are likely highly dose-dependent. If used in appropriate doses it is probably safe for the average user. People with a history of liver or addiction problems should be extra careful with Tianeptine.

Side effects

Interactions

Supplements and drugs can interact with Tianeptine to increase or decrease the positive or negative effects you experience. If you are already using any supplements or drugs, speak with your trusted medical professional before you experiment with Tianeptine. To learn more about the potential interactions between Tianeptine and other substances, use interaction-checker.

Legality

Is your country not included? Learn how to find out if Tianeptine is legal in your country.

Legality Disclaimer

FAQ

Frequently asked questions about Tianeptine

What's the difference between Tianeptine sulfate and Tianeptine sodium?

Tianeptine sodium is the most widely studied and used form of Tianeptine. Tianeptine sulfate is another form of Tianeptine which has been gaining popularity amongst self-experimenters, because of anecdotal evidence of greater efficacy. [33]

Unless otherwise stated, all mentions of Tianeptine on this page regard Tianeptine sodium.

Should you use Tianeptine?

One thing that is certain about the effects of Tianeptine is that we know relatively little about them. There is a lack of high-quality research, especially in healthy humans.

Because of the lack of research on Tianeptine, we never recommend that people use it.

If you have already decided to use it, here are some guidelines to maximize the benefits and minimize the risks.

How much and how often should you dose Tianeptine?

In France where it has been used widely in the treatment of depression, it has been used in 12.5mg doses 3x daily. [14]

How does Tianeptine work?

The mechanisms of action of Tianeptine have not yet been fully discovered by researchers.

Scientists have found that Tianeptine can exert the following neurobiological effects:

Binds to and acts as an agonist at the mu-opioid receptor (in cell study) [19][36]
Activates delta-opioid receptors (in cell study) [37]
Modulates glutamate receptor currents (in rat hippocampal synapses) [38]
Stimulates serotonin uptake (in rat brain synaptosomes and rat and human platelets) [39]

But perhaps its ability to increase neuroplasticity is the most interesting mechanism of action that researchers have found:

"The neurobiological properties of tianeptine involve a dynamic interplay between numerous neurotransmitter systems and the critical ability 1) to restore normal neuroplasticity in circumscribed limbic brain regions and 2) to reverse stress-induced impairments in synaptic glutamate transmission, which plays crucial roles in virtually all key functions perturbed in depressed states." [3]

What time of day should you take Tianeptine?

Large (75mg) doses of Tianeptine didn't have any psychostimulant effects in healthy humans in one study. [32]

This suggests that the drug won't have a negative effect on sleep. But research hasn't investigated its impact on sleep quality.

It has been prescribed historically to be taken three times a day in medical practice, which suggests that it doesn't have a negative effect on sleep if taken in the afternoon or during dinner time.

Listen to your body. If your sleep is less refreshing after a night before which you took Tianeptine, stop taking it in the evening.

It is not sedating [42], so morning use shouldn't impair alertness or energy levels.

How does it feel when you take Tianeptine?

The following qualitative user experience reports and reviews are included to give you an understanding of what the experience of taking Tianeptine is like.

An anecdotal Tianeptine experience report from YouTube

One person said about his two-day experiment with Tianeptine sulfate that it had a "warming effect" at 50mg, strong pain-killing effects at 100mg, but no anti-depressant effects after either dose. [45]

Anecdotal Tianeptine experience reports and reviews from Reddit

One person with a long history of depressive symptoms reported experiencing the following after use of Tianeptine:

"WOW. Immediatly, things started getting better. My mood was up, but I wasn't high, I just felt like how I felt I should have felt if I weren't depressed. Euphoric effects lasted about a week, and then faded. The thing is, I also had co-morbid generalized anxiety, and that went away too! It kind of washed away, not like a wave, but like the tide that retreats itself. I could see it, but only over the course of days.

Now i'm looking back, and... it's been a month I haven't felt this... normal I guess? I'm not ecstatic about life, not all the time, but i'm optimistic, I want to talk to people, just doing my work feels enjoyable, and my stress levels seem way down. I know it feels like i'm selling the stuff here, but this stuff has seriously flipped my world around. And it's not like I hadn't tried every other possibility out there, I exercise a lot, sleep well, eat very well, don't drink, don't smoke, meditate twice a day, but even with all those things, I felt like I could only go so far.

Taking this Tianeptine for a month has really made me realize I had some chemical imbalance, and learned stress responses to certain situations and environment, that I couldn't get rid of, and that Tianeptine seems to have balanced out, it's really crazy!

Sorry if I seem all over the place, it's just I have so much good to say about this substance. There's virtually no side effects, and it's so effective that I would never increase the dose, it's too valuable of a drug to me to abuse." [46]

One person with a history of suicidal ideation experienced suicidal ideation after a significant life event and the use of Caffeine together with Tianeptine. [48]

Another person reported the following:

"While I've found Tianeptine to be very effective in mitigating my negative thoughts and depressive symptoms, I find that the lows that occur in between doses are far worse than anything I feel normally (apart from the once in a blue moon occasion).

For instance, today I found myself with a very short term suicidal ideation, as I was away from my Tianeptine capsules and unable to redose for a short period. Edit: neglected to mention that in this instance I had experienced some negative external stimuli but nothing that should produce depressive symptoms of this magnitude. I had also taken Semax, Selank, Ashwagandha, caffeine, and L-Theanine." [49]

Yet another person reported experiencing suicidal ideation for several hours at a time after use of Tianeptine. [50]

These anecdotes are certainly concerning but of very low quality for assessing the risk that Tianeptine may cause suicial ideation. It appears plausible that Tianeptine's opioidergic mechanisms of action could be the reason for potential suicidal ideation withdrawal symptoms, especially if used in very high doses. Withdrawal symptoms from large doses have been reported in the scientific literature.

Several people have reported using Tianeptine in doses at or below 50mg for several weeks without withdrawal symptoms upon abrupt discontinuation of the drug. [52]

Tianeptine sulphate was reportedly ineffective for several people who tried it. [53]

One person reported the following effects from Tianeptine:

"I notice tianeptine helps get rid of the constant chatter in my brain and helps keep me "in the moment" i know that sounds tacky but its truly one of the few substances that has that effect. It's like meditation in powder form." [54]

And another user reported:

"Firstly for my 2 month review, its amazing stuff. Really good for anxiety, mood and motivation. Negligeble side effects, most notably a more relaxed memory. Indeed one of the best substances I have experimented with. ... As for long term changes in my brain, I feel less anxious and more doing. ... By a 'relaxed memory' I mean its not as sharp as it would be at baseline. I can still remember everything I need to but there is a certain sharpness (in particular to inanimate objects/details in the world around me) that is a bit dulled. ... I think its the happiness/satisfaction/chilled like feelings it gives which causes me to not pay attention to what I don't have to. This doesn't cause me a problem though." [55]

Yet another redditor reported the following:

"One of the rare things work for me is Tianeptine, destroys dysphoria/misery & puts a smile on my face. Please note the dysphoria/misery is baseless (or due to stupid reasons)." [56]

And one person said it improved their well-being, thought patterns, and social life for several days after use:

"I would always be anxious and would not have a fun time in social settings. I struggled to relax, etc. This continuously reinforced a negative feedback loop in my head, which was a viscous cycle leading to more anxiety and less and less self confidence.

Over the weekend I went out several times, and dosed tianeptine rather heavily (100-150mg/night). When on tianeptine (sodium) and drinking, I felt amazing, it completely eradicated my anxiety and really gave me a lot of confidence. I ended up having so much success with women, and being so socially fluid those few nights, it was amazing. And the best part was, the next day after drinking, when I normally have terrible anxiety (a large part thinking about how anxious I was the night before, how weird I acted and couldn't function and people didnt like me, etc), I instead did not feel any anxiety at all pretty much. My twitching even stopped. I felt fine!

It has been several days since I have taken tianeptine, or been drinking, and I have had so much less anxiety. I am wayyy more confident, due to the GREAT social experiences I had while on tianeptine those nights. It really has carried over to my sober life, which is great!!! I never thought it would work this way, but it has so far!!! I'm thrilled!" [57]

The safety of combining Tianeptine with Alcohol is not scientifically proven, so do not use Tianeptine with Alcohol.

Another redditor responded to the person who used the Alcohol-Tianeptine combination with a report of their experience:

"I've been using it in the recommended dose for over a month now and can say my results have been similar. I've conquered the majority of my negative thinking and things are looking up. I faced the same problems as you and they seem to be insignificant now." [58]

This suggests that you do not need to use high doses of Tianeptine to get beneficial effects. Higher doses are likely to lead to significantly more negative side effects.

Studies

Studies conducted on the effects of Tianeptine in healthy humans

Last updated Saturday, June 10, 2023