Antidepressant medications are not as addictive as other medications. Antidepressants abusers do not experience the cravings that other drugs cause, nor do they share the euphoria, addictive behaviors, or adverse effects that many other drugs do. Antidepressants can also cause physical dependence in some people. People who suffer from depression are also more likely to misuse other substances.
Antidepressant addiction can develop in people who never needed the drugs to begin with. Antidepressants have inadvertently led to the misdiagnosis of depression in some people, and this is where antidepressant medications are administered. According to one study, nearly two-thirds of patients with depression were misdiagnosed and given unnecessary antidepressants. The World Health Organization (WHO) estimates that depression is the leading cause of disability worldwide, affecting 350 million people of all ages around the globe.
The National Institute of Mental Health (NIMH) estimates that by the time they turn 18, 3.3 per cent of adolescents will have a depressive disorder, and girls are more at risk than boys. Depression is characterized by episodes of sadness that affect everyday life and functioning. Depression can be diagnosed after two weeks of symptoms and treated with antidepressant medications.
Anxiety disorders affect nearly 18 per cent of the American population, around 40 million people. They are the most common mental illness in the country, as reported by the Anxiety and Depression Society of America (ADSA). These disorders include generalized anxiety disorder (GAD), panic disorders, post-traumatic stress disorder (PTSD), phobias, social anxiety disorder and obsessive-compulsive disorder. Anxiety disorders affect antidepressant medications process the way stress.
Anxiety disorders and depression often co-occur together about half the time, according to ADSA. One in 10 adults over the age of 12 in the United States takes antidepressant medications used primarily to treat depression and anxiety disorders, making antidepressants the third leading type of prescription drug taken in America, as published by the Centers for Disease Control and Prevention, or CDC.
As with any drug or medication, antidepressants are not without side effects and risk factors. The CDC reports that 14 per cent of Americans currently taking antidepressant medications have been taking them for ten years or longer, and less than one-third of those taking one antidepressant have been seen by a medical professional face to face in the past year. Approximately 80 per cent of antidepressant medications are not prescribed by a psychiatrist, as published by NIMH. Taking medications long-term and without proper supervision, medical treatment, and continuous medical evaluations by trained professionals may lead to drug dependency or addiction.
What Are Antidepressants?
Antidepressants work by rebalancing neurotransmitters in the brain, which helps relieve depression and anxiety. Certain mental illnesses and depression are treated with antidepressant medications to reduce symptoms. Antidepressants come in several ways, each of which acts differently.
Many antidepressants, for example, operate by increasing serotonin, a natural chemical in the body that helps to stabilize mood. The antidepressant medications helps in relieving unwanted symptoms such as anxiety and excessive depression. Within the five years, the prevalence of antidepressant medications among adults aged 12 and up was 12.7%, 8.6% among men, and 16.5% among women.
Planning in the long-term While antidepressants are widely used, many people are uncertain about the duration of time they should take antidepressant medications. Doctors usually recommend this form of medication for at least a year to ensure that the patient receives the drug’s full benefit. It is also possible that depression may last from four to eight months, so when you’ve treated depression with antidepressant medications, it will take time for the body to return to normal. If the patient has been taking antidepressant medications for a year, they must decide whether their situation warrants discontinuing the medication or continuing it for a couple more months.
Dependence vs Addiction
Antidepressant dependency is a state of adaptation caused by frequently taking a drug. Certain withdrawal syndromes are associated with abrupt discontinuation or rapid dose reduction of antidepressant medications. The development and expression of Antidepressant Addiction are influenced by genetic, psychosocial, and environmental factors on antidepressant medications. At least one or more of the following habits are present: impaired control over substance use, compulsive use, continued use despite harm, and craving. Even though drug addiction is a treatable condition with a multidisciplinary approach, relapse is typical for people taking antidepressant medications.
There are several different forms of antidepressant drugs on the market today, and research on Addiction’s potential varies. Antidepressant medications, while some high risk, does not affect people who take other medications that similarly impact the brain. Environmental and genetic factors may influence substance abuse or dependence. In the coming year, the National Institute on Drug Abuse (NIDA) estimates that the biological risks of Addiction or drug abuse will rise 40 to 60% of the time due to antidepressant medications.
Medications and drugs alike make chemical changes in the brain. It’s also possible to develop a substance abuse problem if you take antidepressant medications before the brain reaches its full potential, for instance, in adolescence. The use of any prescription drug beyond the scope of its intended or medical help is considered drug abuse. In America, NIDA reports that prescription drugs and alcohol and marijuana are the most commonly abused substances, followed by over-the-counter antidepressant medications. Prescription drugs are generally easy to obtain and falsely perceived as safe since they often come out of a medicine cabinet where a doctor initially prescribed them. The 2013 National Survey on Drug Use and Health (NSDUH) reported that half of all prescription drugs used for recreational or nonmedical purpose were obtained for free from a relative or friend who got them from a doctor. Abusing antidepressant medications increases the risk of Addiction as it increases the risk factors for abuse.
It is essential to understand the difference between addiction and dependency. The disease of addiction necessitates treatment, while dependence may occur naturally due to long-term use of antidepressant medications. Addiction is defined as a chronic and relapsing brain disease wherein the user cannot control compulsive drug use and continues to seek out drugs beyond medical necessity and without regard to adverse physical or emotional consequences. The withdrawal effects of antidepressant medications are both psychological and physical.
Whenever the brain starts relying on chemical transformations caused by drugs, dependence occurs. Antidepressant medications cause the brain and body to become physically dependent on the medication. Addiction may occur as a result of dependency, but not always. The physically reliant person upon antidepressants and relies on them to relieve symptoms will not attempt to increase their dose or engage in any compulsive drug-seeking behavior or violent behavior related to antidepressant medications.
Indications of Addiction
To be officially diagnosed with a substance abuse disorder as defined by the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and published by the American Psychiatric Association, you must have at least two of the following symptoms:
- Taking more of the substance than intended or for a more extended period
- Unsuccessful desire to control substance usage or unsuccessful attempts to stop using the substance
- Substance cravings
- Obsession with the substance
- Substance use interferes with work, school or family obligations
- Cessation of recreation or social events previously enjoyed due to substance use
- Interpersonal relationship damage from substance use and continued use regardless
- Using substance repetitively in physically dangerous situations or circumstances
- Tolerance to substance
- Withdrawal symptoms when a sensor is removed
- Continued use despite harmful physical and emotional consequences
Antidepressant medications can cause substance abuse disorders of varying severity depending on the presence of certain criteria. When one, two or three symptoms exist, the condition is considered mild. In contrast, the presence of four or five symptoms is deemed moderate, and the presence of six or more symptoms is diagnosed as a severe substance use disorder. The severity of addiction to antidepressant medications is affected by the duration of the abuse, the method of abuse, and other genetic and environmental factors.
The Most Common Types of Antidepressant Medications Prescribed, as Indicated by NIMH, Are:
- Selective serotonin reuptake inhibitors or SSRIs, such as Prozac, Paxil, Lexapro, Serafem, Celexa, Luvox and Zoloft
- Monoamine oxidase inhibitors or MAOIs, like Manerix, Marplan, Emsam, Parnate and Nardil
- Serotonin and noradrenaline reuptake inhibitors or SRNIs, including Effexor, Cymbalta and Pristiq
- Tricyclics, like Tofranil and Norpramin
- Norepinephrine and dopamine reuptake inhibitors or NDRIs, such as Wellbutrin and Zyban
- Noradrenergic and specific serotonergic antidepressants or NaSSAs, like Remeron
Antidepressants are believed to function by changing how the brain’s natural messengers, or neurotransmitters, work. Certain neurotransmitters, such as serotonin and dopamine, are partially responsible for mood and positive emotions. Antidepressants often block these neurotransmitters’ reabsorption, thereby changing the chemical balance in the brain and boosting mood. Depressed individuals may have lower levels of some of these natural chemicals, and antidepressant medications can increase their production. Antidepressant medication are proven to improve depressive symptoms between 50 and 65 per cent of the time when treating moderate to severe depression after three months of use, as reported by the Royal College of Psychiatrists.
Most prescribing physicians are moving away from tricyclics and MOAIs due to the side effects and diet restrictions that they may incur and leaning more toward SSRIs. Since depression often co-occurs with other disorders, including anxiety disorders, additional medications such as benzodiazepine anti-anxiety medications, like Valium and Xanax, may also be prescribed in tandem antidepressant medications. This can increase the potential side effects and risk factors if mismanaged or not adequately supervised.
The side effects of antidepressant medications will vary depending on your personal experiences, genetic makeup, and type of medication required. Generally speaking, antidepressants are not thought to be as effective on mild forms of depression but are reserved for more moderate to severe manifestations.
General Health Concerns or Risk Factors May Include:
- Weight gain
- Dry mouth
- Nausea and vomiting
- Irregular heart rate
- Sleepiness or drowsiness
- Sexual dysfunction
- Trouble urinating
- Heightened blood pressure
- Potential for increased suicidal thoughts or tendencies
When you stand up for antidepressant medications, tricyclic antidepressants may cause a dangerous drop in blood pressure. Side effects are increased with the introduction of other drugs or alcohol. If you, or someone you know, are experiencing suicidal thoughts, seek immediate professional help. Consider these potential health concerns with your doctor, and realize that these side effects may be more or less severe than those associated with other antidepressant medications.
Is it Possible to Become Addicted to SSRIs?
There is a lot of discussion surrounding pharmaceutical properties, particularly SSRI drugs, and the addictive qualities of antidepressant medications. It is well known that substance abuse alters the chemical makeup of the brain and interferes with normal neurotransmitter development, much like prescription drugs that interfere with antidepressant medications. Chronic illicit drug and alcohol abuse may lead to physical and psychological dependence on these substances to maintain feelings of balance and normalcy. This dependence may turn into an addiction when the need for substance abuse takes over and excessive amounts of time are dedicated to obtaining the substance, using it, and recovering from its effects. SSRI medications are often mistakenly referred to as “happy pills.” However, they do not seem to produce the same sense of euphoria or artificial happiness that other medicines, including benzodiazepines, do. SSRIs aim to rebalance the brain, not simply increase pleasant feelings, so illicit antidepressant medications do not lead to a high.
Most doctors believe that antidepressant medications are not addictive in the traditional sense. Antidepressants may induce physical dependency, as shown by the withdrawal symptoms that may occur when antidepressants are stopped or reduced. When people stop taking antidepressants unexpectedly, they sometimes experience withdrawal symptoms such as nausea, tremors, and depression.
Antidepressant medications do not supply a euphoric rush like dopamine-producing antidepressants; a few people give up their daily commitments just to find an antidepressant. For antidepressants, there are no cravings, no risky habits, and no examples of long-term Addiction. Snorting antidepressants, especially Wellbutrin, is a popular way to misuse these drugs. However, this does not lead to Addiction to antidepressant medications. When no other options are available, it’s usually done to give the patient a placebo effect when they’re craving their actual drug of choice.
To be classified with an addiction, a tolerance to the drug must be established, leading to drug-seeking behaviour, which doesn’t seem to occur with SSRIs. Long-term use of SSRIs can cause dependency, which can cause withdrawal symptoms from antidepressant medications. This is often mistaken for true Addiction. Research suggests SSRIs are addictive in that they can cause withdrawal and physical dependence, but others disagree, believing that antidepressant medications are not addictive.
SSRI withdrawal symptoms include insomnia, nausea, alteration of touch sensation, and feelings of electrical shocks in the brain. When these symptoms are present, it is referred to as SSRI discontinuation syndrome, and it is not officially a side effect of addiction. A Danish study published in Science Nordic argues that as many as 37 out of the 42 withdrawal symptoms for the known addictive benzodiazepine medications that were discontinued mainly as antidepressant medications with the rise of SSRIs are identical to those experienced during SSRI discontinuation syndrome.
Whether or not an antidepressant and SSRI medications are considered officially addictive, if you are suffering from depression and long-term usage of these medications, you may benefit from specialized treatment for substance abuse and mental health disorders. Stopping antidepressant medications without the help of a doctor or other medical professional is the best approach.
Antidepressants help many people live happier, more active lives, despite the dangers associated with their use. Patients who have been prescribed antidepressants should never avoid taking them without first consulting their doctor.
Depression varies widely from person to person. It is defined by the Mayo Clinic as a mood disorder affecting how you think, behave, and feel. Antidepressant medications is indicated if the person loses interest and is sad all the time. The treatment of depression often requires both medications and behavioural or Cognitive Behavioral Therapy (CBT) to be the most successful. Cognitive-behavioural therapy (CBT) reduces negative thinking and behaviours by practising coping skills. Antidepressant medications can help in this process during recovery. Healthy lifestyle changes such as a balanced, nutritious diet and engaging in physical and mental activity increase natural levels of endorphins and relieve symptoms of antidepressant medication.
Depression often co-occurs with other mental health disorders and substance abuse. Those suffering may turn to illicit substances or alcohol to numb the pain or attempt self-medication. Similarly, the abuse of substances may lead to depression or depressive thoughts. There is no clear correlation between depression and substance abuse disorders. Still, the ADAA estimates depression and substance abuse disorders co-occur at least 20 per cent of the time antidepressant medications are used.
Dual diagnosis or co-occurring disorders in one person is referred to as a dual diagnosis and requires specialized treatment such as antidepressant medications. Evidence-based treatment models combine clinicians’ expertise with scientific research and individual personalities to determine the best course of action. If medical professionals work together to treat both disorders simultaneously, dual diagnosis treatment is most effective. Antidepressant medications may be prescribed in tandem for dual diagnosis. Both depression and substance abuse disorders are then treated as primary disorders.
For individuals who deal with depression, substance abuse, or both, FRN treatment centers provide personalized care plans and antidepressant medications tailored to the individual’s set of circumstances. Family, group and individual therapies and counselling sessions are often combined with medications and peer support or self-help groups. Contact us today by calling 615-490-9376 to determine the best path toward a lasting and healthy recovery by antidepressant medications.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. He is a freelance medical writer specializing in creating content to improve public awareness of health topics. We are honored to have Ben writing exclusively for Dualdiagnosis.org.