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Calls to U.S. poison control centers about an unapproved antidepressant that has opioid-like effects have climbed dramatically since 2015, according to a new analysis published by the Centers for Disease Control and Prevention.

Tianeptine is used as an antidepressant in Europe, Asia, and Latin America. It hasn’t been approved by the Food and Drug Administration. But it’s easy to buy the drug online as a diet supplement or research chemical and is sometimes abused, because it can give users an opioid-like high.

Now, as the opioid crisis continues to flare, health officials are worried it could pose a possible public health threat. In April, Michigan Gov. Rick Snyder passed a measure to reclassify tianeptine as a Schedule II controlled substance after a series of overdoses linked to the drug in 2017.


“In light of the ongoing U.S. opioid epidemic, any emerging trends in drugs with opioid-like effects raise concerns about potential abuse and public health safety,” the authors wrote.

Megan Thielking/STAT Source: Characteristics of Tianeptine Exposures Reported to the
National Poison Data System — United States, 2000–2017, Morbidity and Mortality Weekly Report

From 2000 to 2017, there were 218 calls related to tianeptine exposure recorded in the National Poison Data System. Of those calls, 121 were for people ages 21 to 40, and 119 were classified as intentional exposures.


The spike in poison center calls followed a 2014 paper that showed that the drug works on the opioid receptors and can produce a high. The study found that some of the cases reported to poison control centers included neurologic, cardiovascular, and gastrointestinal issues. In some cases, the symptoms mimicked those caused by opioid toxicity or withdrawal.

Megan Thielking/STAT Source: Characteristics of Tianeptine Exposures Reported to the
National Poison Data System — United States, 2000–2017, Morbidity and Mortality Weekly Report

Also of concern: In 83 of the incidents, tianeptine was used with another drug, including 10 cases in which it was used with opioids and 26 cases in which it was used with phenibut, an unapproved drug that works as a central nervous system depressant and is also used recreationally.

The authors said health care providers should be on the lookout for potential cases of tianeptine abuse or withdrawal and should call poison control centers for guidance if they suspect a patient has used tianeptine.

  • 218 ER admissions in 17 years is hardly an epidemic, especially because the author admits that Tianeptine was not the only drug that many of these patients had taken. ER admissions are often triggered by something as simple as a runny nose.

    • Exactly!
      Readers should be asking why this drug. They chose this particular drug, and the calls to the poison control center, to deceive, titillate and help people feel informed. This is a deliberately deceptive, bit of misinformation appearing to be factual news.

      We need to read between the lines, here. There is no contextual information, by design. No information on the many other legally prescribed pharmaceutical products, that generate calls to the poison control operators. Tianepeptine is the only one not currently marketed by Pharma, so it is safe for it to appear in an article. There won’t be any Pharma Lawyers attacking this publication for a negative mention of one of their products.
      Pharma is currently marketing a number of anti depressants, sedatives, anti psychotics, anti seizure medications, and others for everything from workplace dissatisfaction, to chronic pain, and even opioid addiction. Thanks to loose reporting requirements the number of ER Admissions, poison control calls, “Overdoses” and adverse events caused by those drugs, are not counted. Reporting requirements are not standard by design. The various industry interests decided that factual data could cut into profitability. There is no way to track the number of incidents realted to these brand name pharma products. They are still being marketed as “Better than opioid addiction” with a very successful fear based marketign program. Physician who are afraid to prescribe pain or addiction medications, due to years of persecution, misinformation, and terrifying news stories, will prescribe these drugs freely. When these drugs result in a death, it is attributed to opiates or addiction, anyway.

      Every attention getting story, Advertorial, or misleading factoid about the continuing deaths of despair, is meant to mislead the public an at the same time give the appearance of ‘helping.” The FDA is not tracking any of this, nor are our other regulatory agencies. No one is tracking the number of avoidable deaths, due to these Pharma products, and nearly every number quoted in the popular media, is deliberately deceptive. Between on half to one quarter of all deaths attributed to “opiate overdose” either contain one or more of these off label drugs, or are attributed to other illegal drugs or alcohol. Those numbers are inconvenient for Pharma and the healthcare, or insurance companies.
      People have been so duped by this kind of false narrative reporting, that they don’t ask questions or read between the lines anymore. The reason they chose this drug, is because it is the only one that is not covered by various laws, including the ones on Proprietary information. The number of deaths due to any other pharma product could lead to a Lawsuit, if they were published by any News Site or newspaper.

      We are in an Orwellian alternative fact country now. It is safe to run and out of context article like this, to distract form the facts. These are also deceptive, because they give us the false impression, that someone is keeping track or that Science and data gathering still work. The statistics on the other drugs, marketed for off label use, are Proprietary if they exist at all. There has been no pharma funding for side by side comparisons of these drugs, no meaningful clinic trials. None of these drugs were compared to either doing nothing, or any of the others on the market. There were no long term studies on their effectiveness, or relapse rates, hospitalizations or deaths. Medical Lobbyists told Doctors that keeping track, could lead to “liability” their deepest darkest fear. CMS can only work backwards from billing data, well paid industry lobbyists told Congress that keeping track of the deaths adverse events, suicides and brain damage was “government overreach.”
      They are Gaslighting us all, and no Physicians even noticed that an incredible amount of data is missing. They didn’t notice that advertising replaced factual data. Advertising so pervasive that no one even questions it anymore. The Opiate Epidemic was created by misleading Pharma advertising, while the response over the last ten years has been ineffective, yet no in is questioning any of it.
      We would think a publication like this one would inject a few facts, instead they have to worry about industry retaliation. The Fact that the rates of deaths, suicides, and even ER Admission are rising, have no prompted one question about why, or what are we missing, ought to be terrifying.
      The Administration added even more Industry insiders to the regulatory boards. If we ask why there have been no real prosecutions of the Pharma companies involved at the outset, back in 2000, we would have to point at this kind of misleading alternative fact coverage of it all.
      There is plenty of anecdotal information about repeated “Overdoses” on these Pharmaceuticals, yet no ER has released a clear concise number, that information is Censored.

  • To appear to tackle the epidemic of drug use, they restricted opiates for pain patients, yet the deaths and overdoses continue to spike. None of the terrifying mass media headlines mention any of these other drugs, by design. Pharma marketing insisted anti depressants, anti psychotics and other drugs were a replacement. They have been marketed as a safe alternative. They just don’t count how many deaths, overdoses, and even cases of brain damage their are. In a country where most information comes from marketing, and science is misrepresented as a sales technique, it is no wonder people are dying. The number of deaths, overdoses and adverse events from these types of medications are not counted, even though up to a quarter of all “overdoses” ER Admissions, and deaths are attributed to these drugs. This kind of information is bad for business, according to Pharma lobbyists, uninformed journalists, and industry insiders sitting on regulatory boards. These drugs were extensively marketed as an “alternative” for both chronic pain and addiction. They deliberately conflated those two issues, to sell more ineffective, dangerous and useless drugs. Widespread prescribing of these types of drugs has led to numerous deaths, overdoses, adverse events and suicides, but they remain uncounted. This is what happens when a public health crisis, is an opportunity for fear based marketing. Misinformation is profitable!

    • You’re right that misinformation is profitable. Opioid manufacturers made people believe that they would not become opium addicts if they followed prescription directions and took opioids for over a year. The opioid manufactuers, and the doctors prescribing large amounts of opioids made a bundle, but now we have an epidemic of opium addiciton. Many people have been taking opioids at recommended levels for years, and now they are addicts. I feel very sorry for them.

  • Substance abuse and addiction is rarely about the substance itself but is more about the need to escape reality. Restricting and banning legal substances for pain-relief does nothing to reduce the substance abuse and addiction numbers and always harms those who are in need of pain relief.

    Substance abuse and addiction is not caused by mere exposure to a substance. If it was, then most Americans would be alcoholics, as most of us have drank some sort of alcoholic beverage at least once in our lives. The substance itself is merely the main symptom of a serious complex issue called addiction.

    Those who feel the need to abuse substances, which runs the risk of addiction, do so as a means of escaping reality. They are self-medicating some sort of emotional pain. Some have underlying mental health illnesses and disorders while others have lived through sexual, emotional and physical abuse.

    Other factors involved in abusing substances can include poverty and hopelessness, genetic pre-disposition to addiction. Just as sex not being the cause of sex addiction, food and the act of binge eating not being the cause of food addiction, the mere consumption of liquor not being the cause of alcoholism, ingesting opioid-based medication (particularly for legitimate medicinal reasons) is not the cause of substance addiction.

    Until our government understands what addiction is truly about, they will continue to harm humans in need of adequate pain relief. Each of us are just a second away from becoming a victim of a car accident which renders us disabled and in severe intractable pain that can only be relieved through opioid-based medication.

    In that case, do you want your doctor in charge of your pain control, along with the ability of restoring some mobility due to adequate pain relief or would you rather be in the hands of government bureaucrats with no medicinal training or license to practice medicine? Just something for all of you to think about.

    • Amen Tracy,,,nailed it again……Do we call insulin dependent diabetics,,,”insulin addicts,”’,,,no of course not.Until this generational archaic bigotry,prejudicial idealogy is no longer recognized,,,,,all of us in forced physical pain caused by desease,medical errors 350,000.00 per year,,etc,,will be forced to use death as a method of physical pain control,,proof of this ,is the 6,000 human beings dead after the release of the cdc .”laws,” /guideline..The biggest spike of suicides/DEATHS, in a countries history,EVER!Because our MEDICINE obtained lawfully,thus a lawfull MEDICINE from thee poppy flower,,IS PREJUDICIALLY BEING DEMONIZED BY BIGOTS..and denied access to by bigots.The word addiction in its own right is solely a opinion…any shrink can and has deemed anyone a addict now a days,,,,with absolutely no concern what so ever for the future of that innocent humanbeings future.U deem someone an addict,,,,they will never ever see pain control for any medical condition again in their life time,,,thus being torture,,,Any surgery and broken bones,,any non curable desease process,,,no doctor will ever prescribe that human being a opiate again,,in their life time because of YOUR OPINION, put in writing,,,on their medical records,,the word addict….Do shrinks have that right,,,to torture a human being for their life time??!!Absolutely not!!These shrinks,,non-educated people in a position of power over the medically ill,,,have no education what so-ever in real pain management due to medical conditions,,,and need to get the hell out of pain management,,,for their opinion,,,just killed 5 people today,,via denial of access to effective medicine to lessen severe physical pain from a medical condition..maryw

  • I’m so sick of everyone blaming opiods for killing people.
    I’ve used opiods for my cronic pain for over 20 years!
    This is all BS
    If u follow your dosage and use your brain!!
    u will never overdose and u will live a pain free life.
    No big deal that u all have forced doctors to stop perscribing opiods
    We can all just get them in the street
    Real smart
    Just like proabition in the 30s
    If people want it they will find a way to get it.

    • Your comment is so very true. I have been a chronic pain patient for 31yrs & I am punished for others addictions. As an RN I understand addictive behavior but our CDC & government doesn’t & the only ones who suffer are those in need of proper pain management & addicts. Two very different patients.

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