HATTIESBURG, Miss. (WHLT) – Doctors in Hattiesburg are alerting the Food and Drug Administration (FDA) of the drug tianeptine after they said it’s being widely used in the Greater Hattiesburg area. Specifically, they warn of the opioid withdrawal symptoms they saw in patients who were consuming high daily doses of tianeptine-based products.
The doctors authored the paper “Tianeptine Withdrawal: A Cause for Public Health Concern in Mississippi,” which is being published in the Journal of the Mississippi State Medical Association. It discusses cases that were presented to Forrest General Hospital’s Family Medicine Residency Clinic (FMRC).
Tianeptine isn’t approved by the FDA. According to the doctors, supplements containing the drug are often nicknamed “gas station heroin” because they can easily be bought at convenience stores or online without a prescription. They’re also called “ZaZaRed and “Pegasus.” They’ve become popular amongst people seeking relief from pain, depression and anxiety.
Products containing tianeptine are marketed for various uses including the self-treatment of anxiety, depression, asthma and irritable bowel syndrome. One of the doctors said the lack of FDA approval hasn’t stopped some companies from illegally marketing and selling products containing the drug.
The effects of tianeptine abuse and withdrawal can mimic opioid toxicity and withdrawal. The most commonly reported related clinical effects are agitation, drowsiness, confusion, coma, rapid heart rate, high blood pressure, heart rhythm issues, nausea, vomiting and diarrhea.
The formulation is available in 46 states. Alabama, Tennessee, Minnesota and Michigan have outlawed the sale of products containing tianeptine. Georgia has proposed legislation that would classify tianeptine at a Schedule 1 drug, which refers to drugs with no currently accepted medical use and high risk for abuse.
The doctors said local governments in Mississippi are taking action, too. The Pearl River County Board of Supervisors voted to ban the sale of tianeptine products within county limits.
As a result of the growing concerns, the FDA’s website states, “Tianeptine presents safety risks and can be abused. Cases described in medical journals, in calls to U.S. poison control centers and in reports to the FDA suggest that tianeptine has a potential for abuse. People with a history of opioid use disorder or dependence may be at particular risk of abusing tianeptine.”
The authors of the paper are Robert “Bob” Brahan, MD, Joseph Nosser, PharmD, BCMTMS, and Rambod Rouhbakhsh, MD, MBA, FAAFP, as well as two of FMRC’s recent graduate residents, John Lloyd Martin, DO, and Adam Purvis, DO.