Millions of people in the U.S. and abroad are living with major depressive disorder, and many of them are using medications to manage it. Depression is a condition described as persistent sadness that brings on a loss of interest in activities that were once found engaging or pleasurable. Many will use their medication as prescribed, but others will misuse it or abuse it for various reasons, including people who do not have a depressive disorder.
Antidepressants are among the most widely prescribed drugs on the market. In the U.S., the use of these medications increased by 65 percent in the 15-year period between 1999 and 2014, according to a government report. These drugs help to balance chemicals in the brain (called neurotransmitters) that affect a person’s mood, emotions, and behavior.
The drugs are prescribed for the management of several mental disorders, including Generalized Anxiety Disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). They are also prescribed to treat eating disorders, fibromyalgia, hot flashes, Tourette syndrome, and other conditions. Antidepressants are generally regarded as safe to use because they work slowly over time and are not habit-forming or addictive.
While there are five classes of antidepressants, the two most commonly used are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), which affect serotonin and norepinephrine chemicals in the brain.
Some SSRI medications are:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
SNRI medications include:
- Desvenlafaxine (Pristiq, Khedezla, Ellefore)
- Duloxetine (Cymbalta, Irenka)
- Venlafaxine (Effexor)
Are SSRI Antidepressants Addictive?
No, antidepressants aren’t addictive in the sense that drugs such as heroin, cocaine, or alcohol are, according to the Mayo Clinic. They also don’t produce effects that will make people crave them, like euphoria. However, regular or continued use of these drugs can create tolerance and dependence in the people who take them.
Developing tolerance usually happens as a result of taking a drug regularly. It’s important to note that developing tolerance does not mean a person is dependent on or addicted to a drug. Still, taking a drug outside of its prescribed use can quickly build up one’s tolerance, and that can lead to dependence. Dependence means the body has adapted to the substance and that users could experience withdrawal symptoms if they reduce or stop taking the medicine.
Signs of Antidepressant Abuse
Few cases involving SSRIs have been reported, according to the Monthly Prescribing Reference. However, when abuse is reported, “Patients most often report abusing antidepressants to achieve a psychostimulant-like effect,” the publication writes.
If you (or someone you know) suspect that you could be abusing SSRI medication but aren’t sure, the questions listed below can help you find the answer. Do you:
- Use the medication compulsively or frequently?
- Take it in higher doses than prescribed without consulting a doctor?
- Use it for longer periods than prescribed or use it nonmedically?
- Take it in a manner that is outside its prescribed purpose, such as crushing it up to inhale it, smoke it, or use it intravenously?
- Use SSRI medication along with other substances, such as alcohol or other drugs?
- Seek out various sources to get more of the medication?
- Can’t seem to stop thinking about antidepressant use no matter what?
If any of these signs of abuse are familiar to you, you may want to consider entering a licensed facility that offers a program that can help you address your misuse or abuse of antidepressants. If you decide to stop, you may experience uncomfortable withdrawal symptoms, which is discussed further below.
The Monthly Prescribing Reference advises medical professionals to weigh the risks of patients who may misuse or abuse antidepressants before they start antidepressant therapy, particularly people who exhibit depressive symptoms.
Antidepressants and Withdrawal
A break in antidepressant use can bring on withdrawal symptoms because the body has become used to having the drug in its system. If there is a break or change in use, physical and psychological changes are noticeable. Among these are:
- Blurred vision
- Coordination problems
- Electric shock sensations (called “head zaps”)
- Rebound depression (return of depression symptoms)
- Flu-like symptoms, including muscle aches and chills
- Muscle spasms
- Sensory disturbances
American Family Physician reports that roughly 20 percent of users who suddenly stop their antidepressant use after six weeks experience withdrawal symptoms.According to the Mayo Clinic, this condition is sometimes called antidepressant discontinuation syndrome, and it can last for several weeks. It advises, however, that not all antidepressants are the same, so withdrawal is likely to occur with some more than others.
Professional Treatment Can Help
It is advised that antidepressant use be gradually reduced before it is stopped entirely. If you are experiencing withdrawal symptoms or need help with ending antidepressant misuse or abuse, a medical professional can recommend the best approach for you. This could involve completing a tapering process during medical detox.
Therapies, such as cognitive behavioral therapy (CBT), may also be recommended to help you end your dependence on antidepressants and address the reasons for your use.