Over the past few decades, there has been an increase in antidepressant use – medications that alter your brain chemistry. They are not meant as a quick fix but should instead be part of a structured treatment plan, often being paired with talk therapy and cognitive behavioral therapy. However, it’s important to remember that like any other medication, inappropriate use can lead to problems.
Are Antidepressants Addictive?
The most commonly prescribed antidepressants, like SSRIs, are generally not considered addictive by most medical professionals. This implies that they typically don’t lead to cravings for increased doses or a constant desire for their use.
However, this shouldn’t negate the fact that using antidepressants can certainly foster physical dependence. Cutting back or stopping cold turkey often results in withdrawal symptoms such as nausea, tremors, and depression. While antidepressants are typically less addictive than other substances, like alcohol, opiates, and benzodiazepines like Valium, Klonpin, and Xanax, essentially any medication can be abused if not carefully managed.
Why Are Antidepressants Abused?
Antidepressants were designed to help regulate brain chemistry in those with certain mood disorders, and the unfortunate reality is that some individuals might misuse them. Research shows that individuals already struggling with substance abuse or mood disorders are more likely to misuse antidepressants.
According to this research, the driving factor behind this misuse is typically the desire for psychostimulant-like effect – to feel some sort of high or euphoria.
Common Antidepressants That Are Abused
While antidepressants are intended to improve emotional wellbeing, they can also become a target for misuse. Understanding the types of frequently misused antidepressants is key in promoting awareness and prevention efforts.
Monoamine Oxidase Inhibitors
Monoamine Oxidase Inhibitors (MAOIs) are a class of antidepressants that was identified back in the late 1950s. Two nonselective MAOIs – phenelzine and tranylcypromine – have shown up in literature relating to antidepressant misuse. This may be linked to their enhancement of monoamines which can elevate mood and possibly induce a ‘high’ if misused.
Originally classified as an atypical antidepressant, bupropion is FDA-approved for treating adult depression, seasonal affective disorder, is used as a smoking cessation aid, and bears striking similarities to common drugs of abuse, including amphetamines. Until 2003, this medication was even listed on the World Anti-Doping Agency’s list of prohibited substances due its stimulant-like properties when misused.
There are case reports that describe feeling stimulant and cocaine-like effects when abusing this medication, along with euphoria and a sensation of feeling high. Such misuse typically involves extremely high doses or alternate methods of ingestion which allow the drug to enter the bloodstream more quickly and reach higher peak plasma levels.
This type of misuse significantly magnifies the risk for several adverse effects, including seizures.
Tricyclic antidepressants (TCA) were among the first class of antidepressants to be widely used for treating depression. In the 1970s, there were the first reported cases of TCA misuse. In one study, individuals on a methadone maintenance program were surveyed and 25% reported use of amitriptyline with the intention of achieving euphoria.
Serotonin and Norepinephrine Reuptake inhibitors
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), used to treat depression, anxiety disorders, and sometimes chronic pain, have also been identified as potentially susceptible to misuse.
One reported case involved a 38-year-old man with prior history of both depressive episodes and substance abuse who was taking doses up to 4,050 mg — well beyond the maximum recommended dose by FDA which is 375 mg daily. He admitted that the motivation behind such misuse was to achieve what he termed an “amphetamine-like high.”
A second example identifies another man in his 50s, also with previous instances of substance misuse, using up to about 3,750mg/day of oral venlafaxine, with the aim of becoming extra empathic or sociable while obtaining an elevated emotional state.
Selective Serotonin Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitors (SSRIs), typically prescribed to treat depression, particularly persistent or severe cases, have been noted for relatively minimal misuse risk in comparison to other categories of antidepressants. Nonetheless, there are reported instances of fluoxetine being abused.
One case study recorded a woman suffering from anorexia nervosa who reportedly misused up to 120mg per day for appetite suppression and weight loss.
Another case of abuse included a woman struggling with dysthymia and polysubstance abuse who also began to abuse fluoxetine, noting a stimulant-like effect.
Signs of Antidepressant Abuse
Uncovering antidepressant abuse can be a tricky process, as the signs might often seem like a continuation of pre-existing problems. But discernible shifts in behavior or physical condition could reveal potential troubles.
Examples include “erratic ability to keep appointments, requests for early refills, a sudden request for dose increase in a patient with a previously stable mood on a lower dose of the antidepressant, an indifference to side effects, and a general decline in functioning.”
Friends and family members should also look for typical signs of addiction to any substance, which can include bloodshot or red eyes, poor hygiene, odd or irregular sleeping and eating habits, and slurred speech.
Understanding the risks and recognizing the signs of antidepressant abuse brings us a step closer to effectively addressing this issue. If you, or someone you know are showing these symptoms, seek help from healthcare professionals promptly.
Long-Term Effects of Antidepressant Abuse
Many people affected by depression turn to antidepressants for relief, making them commonly prescribed medications. However, when individuals misuse these drugs, they can end up causing many negative consequences, including:
Dependency and withdrawal
Prolonged use of antidepressants can lead to psychological and physical dependence, making it difficult to stop taking them without experiencing unpleasant withdrawal symptoms, which may include agitation, irritability, dizziness, and flu-like symptoms.
This life-threatening condition occurs when there’s an excessive amount of serotonin – a neurotransmitter responsible for regulating mood, among other things – in your system. The symptoms of serotonin syndrome can range from mild (such as diarrhea, restlessness, shivering) to severe (such as fever, seizures, and coma). Serotonin syndrome can be triggered by taking too much of an antidepressant or combining it with certain drugs or supplements.
Physical health risks
When used improperly, antidepressants may lose their efficacy over time, making it harder to treat depression in the long run.
If you or someone you know is struggling with antidepressant abuse, seeking professional help is essential to avoid these long-term effects and create a healthier future.
The Difficulty to Measure Antidepressant Abuse
Despite the importance, pinpointing the accurate degree of antidepressant misuse has proven to be an uphill task. One predominant contributing factor being a deeply rooted assumption that these medications are immune to abuse.
Even many doctors may underestimate or inadvertently overlook this issue when providing prescriptions, due to their primary focus on effectively treating symptoms of depression or anxiety conditions.
Given that antidepressants don’t typically trigger cravings for increased doses like other anxiety medications – for example, Valium – and generally result in milder euphoria than other substances, they might appear less likely candidates for substance misuse from a clinical perspective.
If you or a loved one is struggling with dependence or addiction, seeking help is always encouraged – with help comes relief, recovery, meaningful support, and lifestyle modifications.