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As millions of people worldwide continue to struggle with depression, the use of antidepressant medications to fight low mood has become common. While these medications have been proven effective in controlling depressive spells, some people also use it for managing other issues, like panic disorder, posttraumatic stress disorder, and obsessive-compulsive disorder, with great success. This excessive use has made experts wonder if using or abusing these medications can lead to addiction.
So are antidepressants addictive? Contrary to popular belief, antidepressants do not cause addiction. However, if people take them for a long time, their body develops a dependence on them and may experience withdrawal symptoms once they stop. These negative symptoms are particularly prevalent and more intense in users who stop consuming them abruptly, making it look as if they are addicted to these medications.
What are some Commonly Abused Antidepressants?
Antidepressant medications can be categorized into different types based on the mechanism of action they adopt to relieve unwanted symptoms in the brain. Some major classes of antidepressants include the following:
SSRI and SNRI
These two classes of antidepressant drugs are the most commonly used medicines across the world. These medicines have fewer side effects and a lesser risk of causing overdose symptoms. Some common examples include Duloxetine and Fluoxetine.
Noradrenaline and Specific Serotonergic Antidepressants
These medicines work like SSRIs but with more strength. People who do not find SSRIs effective in their symptom management may use noradrenaline and specific serotonergic antidepressants to manage their depressive spells. Another reason why this category of antidepressants is popular is that it causes fewer sexual problems than SSRIs.
Tricyclic Antidepressants (TCAs)
Tricycle antidepressants are the oldest type of antidepressant used for depression management. Many experts no longer prescribe them as the first line of treatment because of the unpleasant side effects they lead to. Despite their side effect profile, TCAs are highly effective in treating severe episodes of depression. Some examples of TCAs include clomipramine and amitriptyline.
Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors are also an older type of antidepressant that is now rarely in use. These medicines can lead to severe side effects and pose a very high risk of an overdose; hence, experts do not prescribe them unless they are an absolute indication.
Are Antidepressants Addictive?
The National Institute of Mental Health believes that antidepressants are not addictive. However, people who use it for a long time may develop a dependence on it. Some signs that a person has acquired antidepressants abuse include the following:[1]
Decreased Drug Effect
A person dependent on antidepressant medication needs more and more of this drug to feel the same effect. This is because their brains have developed tolerance to the existing levels of the medication and can only respond to them when the dose is higher than what they are already taking. Upon stopping this medicine, such people may also develop withdrawal effects described later in this article.
Social Problems
Because of increased dependence on antidepressant use, such people start neglecting their social responsibilities and activities.
Impaired Control
People with antidepressant abuse experience intense cravings to use them. At the same time, they have the desire to stop using them because of their adverse effects; however, the intense cravings make it impossible to happen.
Risky Use
People with antidepressant abuse may keep using these drugs in risky situations despite knowing the possible consequences. For example, they may take a sedative antidepressant while performing high-precision work, such as operating heavy machinery or driving which may put them and others in danger.
Antidepressant Addiction Symptoms
Just like other addictions, antidepressant addictions are also detectable in the form of the following signs and symptoms. These symptoms are likely to appear acutely and can be easily noticeable by the afflicted individual along with their loved ones.
Bloodshot Eyes
Certain types of antidepressant medications cause enlargement of the blood vessels in the eyes. As this happens, eyes may acquire a visibly red hue, especially when a person takes a large dose of antidepressants.
Diminished Appearance
Using antidepressants too frequently can trigger weight loss in the addict. Some of these medications may directly lead to this effect, while others adopt an indirect route by reducing appetite and making users emaciated within weeks of use.
Financial Difficulties
Financial difficulties are one of the key indicators of an underlying antidepressant addiction. This type of addiction makes it hard to concentrate on daily tasks; hence, focusing on work and making a living become significantly tricky. Additionally, purchasing more and more of this antidepressant drug can also put a financial strain on the user.
Changes in Appetite
Depending on the type of antidepressant a person is using, these medications can trigger noticeable changes in the appetite of the user. Some people may notice an increase in appetite while others may experience a decrease in it.
Odd Sleep Habits
The effects of antidepressant addiction on sleep are variable. Some people report constantly feeling sleepy, while others find falling asleep or maintaining it throughout the night difficult.
Slurred Speech
Acute use of antidepressants may cause slurring of speech along with other symptoms, such as dizziness and drowsiness.
Antidepressant Addiction: Does it Lead to Withdrawal?
Another sign of antidepressant use and addiction is if an individual stops using them suddenly, they may experience unwanted side effects. As per the National Alliance on Mental Illness, up to 80 percent of people who stop using antidepressants abruptly or drastically reduce their dose may experience discontinuation syndrome, also known as withdrawal symptoms. These symptoms usually appear within a few days of stopping the drug and may continue for weeks.
Discontinuation syndrome or withdrawal from antidepressants can lead to the following categories of symptoms:
- Mood-related symptoms: These symptoms include aggression, low mood, mood changes, panic attacks, anxiety, and agitation
- Digestive symptoms: These symptoms include nausea, abdominal cramping, vomiting, and diarrhea
- Sleep-related symptoms: These symptoms include excessive nightmares, daydreaming, and insomnia
- Somatic symptoms: These symptoms include unexplained fatigue, flu-like symptoms, sweating, headaches, and dizziness
Other symptoms that may appear as a part of antidepressant discontinuation syndrome and withdrawal include the following:
- Cognitive problems
- Jolts or zaps of electricity in the body or brain
- Hallucinations
- Taste changes
- Itchiness
- Tremors
- Muscle pain
- Vision problems
- Itchiness
- Ringing in ears
To avoid experiencing these withdrawal symptoms, experts recommend gradually reducing their antidepressant dose over several weeks instead of doing it abruptly. It is also important to do this tapering under the supervision and guidance of a doctor. Evidence also suggests that people seem to develop progressive tolerance to these medicines over time. This means that the same dose of this medication may become less effective with time; hence, a user may need to increase it or change it altogether.
Long-Term Side Effects of Antidepressants
If antidepressant dependence continues for a long time, it may lead to more permanent side effects that are hard to get over. Some of these long-term side effects include the following:[2]
Sudden Cardiac Arrest
Long-term use of antidepressants can negatively affect heart function, increasing the risk of sudden cardiac arrest and even immediate death.
Changes in Heart Rhythm
Many types of antidepressants have been known to increase or decrease the heart rhythm, sometimes to a dangerous extent.
Decreased Sex Drive
Long-term use of antidepressants can lead to decreased sex drive while causing symptoms like erectile dysfunction in males and vaginal dryness in females.
Inability to Orgasm
Abusing antidepressant medication can make it difficult for users to reach orgasm.
Nausea
Nausea is one of the most common side effects of using antidepressants in many. These symptoms may sometimes persist for weeks, even after you stop taking the medication.
Dizziness
Antidepressant medication can alter sleep patterns, affect coordination, and cause symptoms like confusion, fainting, and dizziness.
Antidepressant Dependence Treatment Protocols
According to the National Institute on Drug Abuse, addiction is a treatable condition; however, the process may be tedious and uncomfortable. As a long-term illness, it may be impossible to control these addictive behaviors within days, and full recovery usually includes long-term treatment. Antidepressant addiction treatment aims to address the underlying behaviors and issues that led to this addiction in the first place. Some treatment modalities that experts use to keep antidepressant abuse under control include the following:
- Behavioral counseling
- Inpatient stabilization and treatment in severe cases
- Medication to control withdrawal and relapses
- Evaluation and appropriate treatment for co-occurring mental health issues such as, anxiety, posttraumatic stress disorder, and substance abuse
- Long-term follow-up to prevent relapse
The follow-up or aftercare programs typically include regular participation in community support programs, such as family-based recovery systems and Antidepressants Anonymous.
FAQs
Are antidepressants risky?
In general, antidepressant medications are not risky and can prove highly beneficial for treating low mood and other associated symptoms. However, they may lead to long-term side effects and dependence in some people. Keep in mind that this risk is exceptionally high with certain types of antidepressant drugs. To keep the risks to a minimum, strictly stick to the prescription dose and report to your doctor once you notice any signs of dependence.
What is the difference between antidepressant addiction and dependence?
Antidepressant dependence refers to a state caused by regular intake of this medication. Someone dependent on these drugs may experience unpleasant signs and symptoms, especially after they abruptly discontinue or reduce their use. Antidepressant addiction, on the other hand, is a primary neurobiological disease with environmental, psychosocial, and genetic factors influencing its manifestation and development. This condition includes symptoms like compulsive use, impaired control of drug use, and continued use of the medicine despite harm.
Can antidepressants get you high?
Unlike many other mood-improving medications, antidepressant drugs cannot make you high. These medications slowly lift an individual’s mood and do not cause a sudden rush of feelings. Many people, therefore, combine them with other drugs or alcohol to increase their effects or experience a high.
What happens if a person who does not have depression starts taking antidepressant medications?
Experts warn people to be cautious about using antidepressants, especially if they are not suffering from depression. Research has shown that certain varieties of antidepressant medications can lead to subtle changes in the structure and function of the brain, especially in people who are not depressed.
References
1 Haddad P. (1999). Do antidepressants have any potential to cause addiction? Journal of psychopharmacology (Oxford, England), 13(3), 300–307. https://doi.org/10.1177/026988119901300321
2 Cartwright, C., Gibson, K., Read, J., Cowan, O., & Dehar, T. (2016). Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient preference and adherence, 10, 1401–1407. https://doi.org/10.2147/PPA.S110632
