Abstract
Tianeptine, an atypical antidepressant prescribed in several countries, is not approved for medical use in the United States. Despite this, it is widely available as an unregulated supplement, popularly known as "gas station heroin," contributing to a growing public health crisis characterized by dependence, severe withdrawal, and overdose. We present the case of a 22-year-old male with major depressive disorder who developed severe tianeptine use disorder. He presented with worsening depression and suicidal ideation, with his psychiatric symptoms substantially exacerbated by cycles of intoxication and withdrawal. The patient declined referral to medication-assisted treatment, highlighting ongoing barriers to care. This case underscores diagnostic challenges when psychiatric symptoms mask underlying substance use disorders and emphasizes the urgent need for clinician awareness, patient education, and regulatory action.
Recommended Citation
Kandra, Kalyan, Gajagowni, Raghavendran, Fernandez, Gabriela A, Polechonski, Natalie and Blewett, Brandon P. "Gas Station Heroin: A Case Report of Tianeptine Use Disorder and a Literature Review.." Cureus 17, No. 10 (Oct 2025): e95153. doi:10.7759/cureus.95153.