As the popularity of alternatives to mood, pain, and self-medication has grown, two names have been popping up more and more in both headlines and on the shelves of gas stations alike: tianeptine and kratom.
Both have attracted attention due to their similar opioid-like effects, use as self-medication in treating depression, anxiety, and pain, and potential abuse and dependency. Yet what are these substances? What is their comparison? And what are the most important distinctions regarding their effects, safety, and legality?
In this blog, we’ll explore tianeptine vs kratom, clarifying misconceptions and helping you make informed decisions.
What Is Tianeptine?
Tianeptine is a synthetic compound originally developed in France in the 1960s as an antidepressant. It is marketed under brand names such as Stablon, Coaxil, and Tatinol.
It is prescribed in various European, Asian, and Latin American countries to treat major depressive disorder, anxiety, and occasionally even irritable bowel syndrome.
Tianeptine differs in mechanism of action from the classic tricyclic antidepressants and is commonly referred to as an atypical antidepressant.
How Does Tianeptine Work?
- Opioid Receptor Activity: Recent studies have found that tianeptine is an unusual agonist of the mu-opioid receptor, the same receptor that binds drugs such as morphine and oxycodone.
- Serotonin Modulation: Although initially, tianeptine was considered a drug that potentiates serotonin reuptake (inverse of SSRIs), currently, it is considered that its antidepressant and anxiolytic properties are mediated through the opioid receptors and glutamate modulation.
- Clinical Use: It is used as an antidepressant and anti-anxiety medication; however, when used in doses higher than prescribed, it may cause euphoria and opioid-like effects, thus giving rise to misuse and dependence.
Tianeptine in the U.S.
- Not FDA-Approved: Tianeptine has no medical indication in the U.S. but may be occasionally sold illicitly as a “dietary supplement” or “gas station drug” and branded as “Zaza” or “Tianna Red”.
- Risks: Reports of tianeptine abuse, overdose, and deaths, with or without interactions with other substances, have prompted the FDA and poison control centers to issue warnings.
Understanding Kratom and its origins
Mitragyna speciosa, also known as kratom, is a tropical tree belonging to Southeast Asia. Traditionally, its leaves have been taken in the form of a stimulant and painkiller over the centuries. Kratom is offered in the West in the form of powders, capsules, teas, and extracts.
How Does Kratom Work?
- Alkaloids: Mitragynine and 7-hydroxymitragynine are the main active constituents of kratom, exerting effects as partial agonists at mu-opioid receptors, along with effects at serotonin, dopamine, and adrenergic systems.
- Dose-Dependent Effects: Low doses of kratom are stimulant (as is caffeine); higher doses are sedative and analgesic, like weak opioids.
- Traditional and Modern Use: Kratom is taken to relieve pain, elevate mood, and give energy, as well as for self-medication to treat opioid withdrawal.
Kratom in the U.S.
- Legal Status: Kratom is legal on the federal level, though not approved by the FDA. Its sale is prohibited or limited in some states and municipalities.
- Risks: There is a dependence and withdrawal associated with kratom, and side effects including nausea, dizziness, and in rare cases, other serious adverse outcomes.
Kratom vs Tianeptine: Kratom Comparison With Tianeptine
Before we explain the reasons people may muddle and misunderstand products containing tianeptine and products containing kratom, let’s explain where each substance originates, how each one works, and how they differ culturally and legally.
1. Origins
Kratom:
The traditional name used for the Mitragyna speciosa tree species is Kratom while referring to the plant-based materials made from its leaves. The name kratom encompasses both the tree species Mitragyna speciosa and all materials derived from its foliage.
Companies source a large percentage of the kratom leaf material in kratom powder, kratom tea, and other types of kratom products in Indonesia. Nurturing warm and moist environments makes the trees unsuitable for most North American gardening regions.
Researchers, together with hobbyists, cultivate kratom trees throughout Florida’s tropical environment, or they achieve this cultivation by keeping the trees in enclosed facilities in areas with colder climates.
Tianeptine:
Scientific laboratories developed this artificial substance during the late 1960s. Pharmaceutical agencies obtained patents for this substance and marketed it through Stablon and Tynept, along with Coaxil trade names.
2. Mechanisms of Action
Kratom:
Many active alkaloids present in kratom leaves create their psychoactive properties through multiple biochemical pathways, along with one another.
Both typical binding at the mOR receptors and other unexplained factors contribute to the effects of the kratom’s most abundant alkaloid component named mitragynine.
In addition to working at mOR receptors, mitragynine demonstrates biological activity on serotonin and adrenergic receptors and modulates dopamine receptor functions.
Tianeptine:
The compound has a shape similar to tricyclic antidepressants (TCAs) yet functions differently from standard TCA medication.
The latest research demonstrates that tianeptine functions at opioid receptors even though it was previously considered to be an SSRE.
3. Usage and Risks
Kratom:
Many individuals choose kratom-containing products for their motivational purposes instead of consuming caffeinated drinks.
People use kratom products in social interactions to manage their mood and choose these products as a non-alcoholic choice. Several kratom users practice drug substitution through the use of kratom to diminish their habits of using other substances.
Long-term usage of kratom has two negative effects: nausea and dizziness, while its regular ingestion makes it habit-forming.
Tianeptine:
Tianeptine is prescribed by healthcare providers to treat cases of depression and anxiety.
This medication creates side effects that include constipation with possible drowsiness and potential addiction to the drug.
The United States has reported cases of people consuming drug amounts exceeding 10 times the typical medical prescription, which leads to enhanced adverse effects and physiological addiction.
Potential Benefits of Kratom
Kratom has gained popularity for its potential benefits, which can vary depending on the strain and dosage:
- Energy and Focus: Low doses of white or green vein kratom may provide a stimulant-like effect.
- Mood Enhancement: Kratom may help improve mood and reduce feelings of stress.
- Pain Relief: Red vein kratom is often used for its potential analgesic properties.
- Relaxation: Higher doses of kratom may promote relaxation and calmness.
Potential Benefits of Tianeptine
Tianeptine is primarily known for its antidepressant and anxiolytic effects. Some of its potential benefits include the following:
- Mood Improvement: Tianeptine may help alleviate symptoms of depression.
- Anxiety Relief: It has been shown to reduce anxiety in some individuals.
- Neuroprotective Effects: Tianeptine may support brain health by modulating glutamate levels.
Tianeptine and Kratom: Similarities and Misconceptions
Why Are They Often Confused?
- Opioid-Like Effects: Both substances interact with opioid receptors, producing euphoria, pain relief, and a risk of dependence.
- Self-Medication: Both are used by some for self-treatment of depression, anxiety, and opioid withdrawal.
- Gas Station Drugs: Both have been sold in convenience stores and online, often with misleading marketing.
Crucial Differences
- Natural vs. Synthetic: Kratom is a plant-derived product; tianeptine is a laboratory-made pharmaceutical.
- Regulation: Tianeptine is more strictly regulated internationally, while kratom occupies a legal gray area in the U.S..
- Potency and Safety: Tianeptine, especially at high doses, can be far more potent and dangerous than kratom, with a higher risk of overdose and death.
Tianeptine vs Kratom: Safety and Side Effects
Tianeptine
- Side Effects: Drowsiness, confusion, agitation, nausea, vomiting, rapid heartbeat, high blood pressure, slowed or stopped breathing, coma, and death.
- Addiction Potential: High, especially when used in large doses or for prolonged periods. Withdrawal can be severe and opioid-like.
- FDA Warnings: The FDA has warned consumers not to purchase or use tianeptine products due to serious risks, including overdose deaths.
Kratom
- Side Effects: Nausea, vomiting, constipation, dizziness, drowsiness, increased urination, and, at high doses, sedation or agitation.
- Addiction Potential: Moderate. Regular, high-dose use can lead to dependence and withdrawal, but withdrawal is generally milder than with tianeptine or traditional opioids.
- FDA Warnings: The FDA has seized kratom products due to safety concerns and has not approved it for any medical use.
Can You Mix Tianeptine and Kratom?
Tianeptine and kratom should not be mixed. These two substances act on opioid receptors and are broken down by the same liver enzymes (CYP3A4), which could result in drug interactions, excessive sedation, and the elevated probability of overdose and toxicity.
When they are combined, they can slow metabolism down, extend their effects, and cause severe side effects such as respiratory depression and death. It is important to first seek medical advice before mixing any substances that slow down the central nervous system.
Final Thoughts
The nature of tianeptine and kratom is wholly dissimilar, as the former is a synthetic antidepressant with strong opioid effects and the latter is a natural plant with weaker, dose-dependent opioid-like effects.
They both have chances of dependence, withdrawal, as well as having serious side effects, especially when abused. Tianeptine is linked to an increased chance of overdose and is not accepted as a medicine in the U.S. Kratom is authorized in numerous conditions but is neither FDA-approved nor non-addictive.
Having read this article, be cautious and aware of the dangers of self-medicating with either of the two substances, and get the help of a medical practitioner should you or someone you know be doing the same.
They should not be regarded as safe or approved methods of treating depression, anxiety, or opioid withdrawal outside of medical control.
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