Generally, antidepressants are not considered addictive, and they don’t cause users to have cravings (according to WebMD).
These non-addictive antidepressant medications are classified as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Both work by inhibiting certain receptors in the brain that relieve major depression.
However, some medications treat depression and don’t fall into the antidepressant category. These medications are in the benzodiazepine class, and are primarily administered to people with sleep, anxiety, or mood disorders.
While SSRIs and SNRIs are considered to be safer than benzodiazepines, they can produce withdrawal or discontinuation symptoms after users stop taking them. They are also able to produce a number of concerning health complications. When antidepressants are ingested with alcohol and other drugs, they can be fatal.
Keep reading to find out more about the reasons why antidepressants can be harmful when misused and the options for professional treatment.
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About 322 million people around the world have been diagnosed with depression, which is a severe mood disorder. Depression is described as persistent sadness exemplified by an overall loss of interest in activities they previously found pleasurable.
The principal authority for psychiatric diagnoses is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
It states that a person must experience five or more symptoms during the same two-week period, and at least one of the symptoms should be a depressed mood or a loss of interest or pleasure.
More specifically, the following criteria are needed to diagnose someone as having depression:
For a diagnosis of depression, these symptoms must cause someone clinically significant distress or impair them in their social life, career, or other areas of their life. In additin, the symptoms must not be a result of substance abuse or another medical condition.
Antidepressant medications don’t cure depression, but they are prescribed to treat the symptoms that come with depression. While there are several classes of antidepressant medications, SSRIs and SNRIs are most commonly prescribed.
SSRIs (Selective Serotonin Reuptake Inhibitors) are prescribed to treat symptoms of depression that are moderate or severe. They work by increasing levels of serotonin, the neurotransmitter that modulates memory, learning, reward, and cognition in the brain. SSRIs block the reabsorption of serotonin in the brain, which makes the chemical more readily available.
The Food and Drug Administration (FDA) approved the following SSRIs to treat depression:
SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) also treat depression, as well as anxiety disorders and chronic pain. SNRIs work by blocking the reabsorption of serotonin and norepinephrine in the brain. In effect, SNRIs impact brain chemistry and communication in neural circuits, which regulates the mood and provides relief from depression (according to the Mayo Clinic).
The following SNRIs have been approved to treat depression:
Other, less commonly prescribed SNRIs include tricyclic and monoamine oxidase inhibitors (MAOIs).
Tricyclic antidepressants include amitriptyline, doxepin, imipramine (Tofranil), nortriptyline (Pamelor), and desipramine (Norpramin). They are less frequently prescribed than other antidepressants because they cause more side effects.
MAOIs are typically prescribed after other antidepressants have proven to be ineffective. These medications can have serious side effects, and they include tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan).
The last class of SNRIs is atypical antidepressants, which includes mirtazapine (Remeron), bupropion (Wellbutrin, Aplenzin, and Forfivo XL), trazodone, vortioxetine (Trintellix), and vilazodone (Viibryd).
Although traditional antidepressants aren’t considered addictive, the FDA requires them to carry a black-box warning because their use can increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults under 25 (particularly in the first few weeks after one starts taking an antidepressant, or after the dosage has changed).
There is also a debate about whether SSRIs and SNRIs can become addictive. While they are formulated not to, they have side effects and withdrawal symptoms that make them dangerous when misused.
As with any substance, the misuse of antidepressants can lead to an overdose, especially if they are abused with other substances. When both medications are taken alone, SSRI and SNRI overdoses rarely lead to death. However, while a typical dose of SSRI may range between 20 to 80 milligrams, a 520-mg dose of fluoxetine has proven to be fatal (according to Healthline).
A typical dose of an SNRI such as venlafaxine ranges from 75 to 225 mg a day, but a 2,000-mg dose has resulted in death.
Overdosing on antidepressants can put users at risk for developing serotonin syndrome, which is caused by an excessive accumulation of serotonins in the body. An overproduction of serotonin can produce mild symptoms (such as shivering and diarrhea) or severe symptoms (such as seizures and fevers). Serotonin syndrome can also be life-threatening.
Serotonin syndrome typically occurs within several hours of taking a new drug or increasing the dose of a drug (according to the Mayo Clinic).
The life-threatening effects of severe serotonin syndrome are seizures, irregular heartbeat, high fever, and unconsciousness.
The dangers of using antidepressants become magnified when people take them with alcohol or other drugs, including the risk of toxicity and death (according to Healthline).
If any class of antidepressants has the potential for becoming addictive, it’s benzodiazepines (or benzos). The longer a user takes any of them, the more likely they are to develop a dependence that can evolve into an addiction.
When someone is addicted to a substance, they typically exhibit compulsive, drug-seeking behavior, so obtaining the substance becomes their primary motivation.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists 11 criteria for drug addiction, which help clinicians diagnose this condition. If someone shows at least two of these symptoms over a 12-month period, they may have an addiction disorder. SSRIs and SNRIs may not be as dangerous or addictive as benzos such as Valium and Xanax, but they can still compel users to display the signs of addiction listed below:
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Discontinuation syndrome can present itself when antidepressant use is reduced, interrupted, or wholly discontinued. This form of withdrawal can produce a range of symptoms, including nausea, insomnia, anxiety, sensory changes, and poor balance. Discontinuation syndrome can occur within three days, and it can last up to several months.
It should be noted that the discontinuation symptoms are not the same for every SSRI medication. Drugs with a shorter half-life produce a more common discontinuation reaction. Of all the antidepressants, fluvoxamine (Luvox) has the shortest half-life, so it has the highest severity of discontinuation symptoms.
In the case of serotonin and norepinephrine reuptake inhibitors, venlafaxine (Effexor) has the shortest half-life, so it produces the fastest discontinuation symptoms.
Generally, antidepressant medications aren’t addictive, and overdosing isn’t fatal. However, they can produce a number of troubling and toxic effects that can endanger your health, and these effects are greater with benzos.
When any of the aforementioned substances are used with alcohol or other drugs, the risk of severe health complications and death increases.
If you fall into any of those usage categories, professional addiction treatment can help you get sober. Even more importantly, it can spare you the damaging health complications that accompany misuse and abuse.
In a professional program, you will meet with clinical staff to determine the appropriate recovery plan. For cases of severe addiction and polysubstance abuse, you should undergo medical detoxification, which safely and comfortably removes these substances from your body.
Residential treatment involves staying at a facility and receiving comprehensive care and therapy. It’s the best treatment for benzodiazepine addiction and polysubstance abuse. In residential treatment, you’ll receive access to a range of evidence-backed therapies. To maximize the effectiveness of any residential program, a minimum of a 90-day stay is recommended (according to the National Institute on Drug Abuse).
If your misuse solely involves antidepressants, an outpatient program is the most appropriate option. In outpatient, you can attend therapy and counseling sessions on a part-time basis while living at home or pursuing another arrangement (such as sober living).
In either case, you’ll receive counseling designed to help you discover the root of your addiction. You’ll also be given education and life skills to help you sustain your sobriety. Once your treatment has completed, the clinical staff will connect you to aftercare and alumni programs that provide a supportive and encouraging community for your recovery.
Let us help you find a specialized and comprehensive treatment program that can help you reclaim your health and wellbeing.
For a free and confidential consultation with one of our specialists, call 855-808-5454 now, or contact us online. These professionals are available around the clock to help you navigate your treatment options, verify your insurance, and answer any questions you have.
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Are Antidepressants Addictive? (n.d.). from https://www.psychologytoday.com/us/articles/200307/are-antidepressants-addictive
Depression. (n.d.) from https://adaa.org/understanding-anxiety/depression
Hartney, E., & Gans, S. (n.d.). What Are Some Criteria for Substance Use Disorders? from https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926
Harvard Health Publishing. (n.d.). Going Off Antidepressants. from https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
How Antidepressants Work: SSRIs, MAOIs, Tricyclics, and More. (n.d.). from https://www.webmd.com/depression/how-different-antidepressants-work#1
Kowalski, J. (2018, December 03). Guide to Drug Addiction: Symptoms, Signs, and Treatment. from https://delphihealthgroup.com/addiction/
Liapko, G. (2019, January 09). Can Antidepressants Actually Be Addictive? from https://delphihealthgroup.com/dual-diagnosis-treatment/antidepressants/
Selective Serotonin Reuptake Inhibitors (SSRIs). (2018, May 17). from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). (2016, June 21). from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970
Serotonin Syndrome. (2017, January 20). from https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
Tartakovsky, M. (2018, October 08). SSRI Discontinuation or Withdrawal Syndrome. from https://psychcentral.com/lib/ssri-discontinuation-or-withdrawal-syndrome/