By Carole Tanzer Miller HealthDay Reporter
TUESDAY, June 17, 2025 (HealthDay News) — The small, colorful bottles hawked at convenience stores, smoke shops and filling stations as cognitive supplements or energy are often called “gas station heroin.”
And, the U.S. Food and Drug Administration (FDA) warns that they pose similar risks of addiction and life-threatening side effects.
Amid a rise in calls to U.S. poison control centers, it recently reminded health professionals of the “magnitude of the underlying danger of these products.”
Sold under such names as ZaZa, Tianaa, Pegasus, TD Red and Neptune’s Fix, the products contain an unapproved ingredient — tianeptine — that can lead to addiction and dangerously depress breathing, according to the Associated Press.
Tianeptine is sold in a number of countries as a government-approved treatment for depression.
But the FDA has never approved it for any medical condition in the U.S. It cannot legally be sold as a dietary supplement or added to foods or drinks.
For more than a decade, however, poison control centers nationwide have seen an uptick in calls linked to the ingredient.
“You never quite know what’s in that bottle,” Dr. Diane Calello of the New Jersey Poison Information and Education System told the AP. “It’s important for people to know that even if they have used a product before, they could get a bottle that contains something very different from what they’re looking for.”
Under-the-radar firms still sell it, though, technically, it’s illegal. Calello explained that it falls under a gray area of consumer supplements or products that are not regulated or tested the same way a medication would be.
Her team documented a cluster of emergency calls in New Jersey last year linked to a flavored elixir called Neptune’s Fix, which contained tianeptine. After drinking it, people experienced rapid heartbeat, low blood pressure, seizures and distress. More than a dozen needed intensive care.
Without FDA approval or evidence, many tianeptine products claim to help treat conditions such as addiction, pain and depression.
The FDA sent a warning letter to the maker of a product called Tianna in 2018. It claimed to provide “an unparalleled solution to cravings for opiates.”
Though it is not an opioid, tianeptine affects the brain in a similar way — and carries some of the same risks of opioids, including the potential to dangerously depress breathing, the AP said.
“That’s what tends to get people into trouble,” Dr. Hannah Hays of Nationwide Children’s Hospital in Columbus, Ohio, said. “They use it for opioid-like effects or to self-treat opioid withdrawal and that can lead to slow breathing and problems like that.”
She emphasized that people dealing with depression, anxiety, pain or opioid addiction should see a health care professional to get an approved treatment.
Between 2018 and 2023, tianeptine-related calls to U.S. poison control centers skyrocketed 525%, according to a data analysis published earlier this year. Medical care was required in about 4 in 10 cases and more than half of those involved needed critical care, the AP reported.
The emergencies owe in part to products that have become more potent and dangerous, experts say. The New Jersey researchers who analyzed Neptune’s Fix found that it contained synthetic cannabis and other drugs.
While tianeptine is not listed in the federal Controlled Substances Act, which bans drugs like heroin and cocaine that have no medical use or a high likelihood of abuse. But about a dozen states, including Alabama, Georgia, Michigan, Tennessee and Ohio, restrict or ban it.
Until recently, the AP reported, Alabama had the highest rate of tianeptine-related calls in the South — up more than 1,400% between 2018 and 2021. Calls began to drop after the state passed restrictions, while calls in other southern states continued to rise.
More information
The U.S. Food and Drug Administration has more about “gas station heroin.”
SOURCE: Associated Press, June 14, 2025
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