From Antidepressant Tianeptine to Street Drug ZaZa: A Narrative Review

Tianeptine is often incorrectly described as a selective serotonin reuptake inhibitor, but it actually µ-opioid receptor agonist with anxiolytic effects. It has been approved since the last 1980s in about 24 countries treatment for depression, was never cleared to market United States this purpose. Nevertheless, tianeptine joined billion-dollar US of nootropics ZaZa or Tianna Red and widely available online small shops without prescription, point that nicknamed “gas station heroin.” While therapeutic dose range 25 50 mg/day, abusers may take 100 times amount. Tolerance occurs rapidly users who seek recapture short-lived euphoric effects drug have more more. Social media peer-support sites those trying discontinue tianeptine. associated multiple side at high doses along dependence, withdrawal symptoms, toxicity, respiratory even mortality. Agitation presenting symptom than toxicity. used by polysubstance be unaware drug’s dangers. Few clinicians are aware most urine assays do not screen it. Greater awareness needed steps must taken heroin” emerging new public health threat.