Our understanding of mental health is constantly growing, which means that more people are seeking treatment for mental health issues. Antidepressants are a first-line treatment for many mental health disorders, but there are risks that come with their use.
With prescription drug addiction currently one of the biggest health concerns in the country, it is certainly logical to question whether antidepressants can lead to addiction. Understanding what antidepressants are and how they work can help answer this question.
What Are Antidepressants?
Medical News Today defines antidepressants as medications given to patients with depressive disorders to help reduce symptoms. They work by correcting chemical imbalances in the brain that cause changes in a patient’s behavior and mood. Antidepressants are used for a number of different mental health conditions, such as depression, anxiety, panic attacks, obsessive-compulsive disorders and post-traumatic stress disorder.1
Antidepressants also treat a number of other medical conditions, such as:
- Chronic pain
- Smoking cessation
- Premenstrual Dysphonic Disorder
- Sleep issues2
In 1996, 13.3 million Americans took antidepressants; in 2010, the number rose to 23.3 million. Researchers and those in the mental health profession attribute the increased use of antidepressants to a better understanding of mental health disorders overall, and the lessening of the negative stigma previously associated with mental health treatment. The Chicago Tribune recently reported that the number of Americans who say they’ve taken an antidepressant in the past month increased by 65 percent between 1999 and 2014.3
There are several categories of antidepressants, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and noradrenaline reuptake inhibitors (SNRIs)
- Noradrenaline and specific serotonergic antidepressants (NASSAs)
- Monoamine oxidase inhibitors
SSRIs are among the most commonly prescribed antidepressants. They work by selectively preventing the brain from reabsorbing serotonin, a neurotransmitter (chemical) that helps the brain cells send and receive signals.4
How Common Are Antidepressants?
There is good reason to be concerned about the potential side effects of antidepressants: drugs in this category are among the most widely prescribed medications in the United States. According to statistics from Harvard Medical School:
- Approximately 10 percent of American adults are taking antidepressants.
- Nearly one-fourth (23 percent) of women in their 40s through 50s are taking antidepressants.
- Antidepressant use in the US increased by over 400 percent between 1994 and 2008.
- More than twice as many American women as men take antidepressants.
By far the most popular antidepressants in the country are SSRIs, or selective serotonin reuptake inhibitors. These drugs have become frontline treatment for depression because they have fewer side effects and produce better results than older antidepressants. SSRIs work by increasing the level of serotonin — a naturally produced chemical that affects mood, energy levels and sleeping patterns — in the brain. SSRIs are also prescribed for other mental health conditions, including anxiety disorders, panic disorder, obsessive-compulsive disorder, social phobia and certain eating disorders. Some of the most popular antidepressants in the SSRI family include the following:
- Prozac (fluoxetine)
- Celexa (citalopram)
- Paxil (paroxetine)
- Zoloft (sertraline)
- Luvox (fluvoxamine)
Other categories of antidepressants include the serotonin-norepinephrine reuptake inhibitors (SNRIs), serotonin antagonists and reuptake inhibitors (SARIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These medications are not prescribed as frequently as SSRIs because they tend to have more severe side effects, as well as more drug and food interactions.
Unlike other prescription medications, antidepressants are usually not taken for recreational reasons. Taking large doses of antidepressants will not produce a euphoric high, like prescription pain medications, nor will antidepressants cause a burst of energy, like the amphetamine-based drugs used to treat ADHD. However, an overdose of antidepressants — especially TCAs — can have dangerous side effects, such as:
- Irregular heartbeat
- Respiratory depression
Antidepressant medications can be toxic at high doses. These drugs should always be taken under a doctor’s supervision to avoid dangerous side effects.
Can You Become Addicted to Antidepressants?
Answering the question of whether antidepressants can lead to addiction is not a ‘yes’ or ‘no’ proposition. The concept of tolerance is a big factor in determining whether or not a substance is addictive. Tolerance happens when a patient no longer responds to the presence of a drug in their system and needs more of the substance to produce the same results.
For example, according to PsychCentral, one of the symptoms of alcoholism is an increased tolerance. An alcoholic not only needs to consume more alcohol to get intoxicated, but even regular, moderate amounts of alcohol do not cause any feelings of inebriation. Therefore, their tolerance for alcohol is dangerously high.5
When it comes to antidepressants, the risk of tolerance is lower because, unlike other substances, more of the drug doesn’t produce a better or different experience.
This means addiction to antidepressants are extremely rare. There are exceptions, of course, like when patients have a history (or family history) of substance abuse or other risk factors.
Another factor in the differentiation of antidepressants from most of the other mood-altering drugs is that when a patient is weaned off the antidepressant, they will not have the painful and dangerous withdrawal symptoms that occur when a patient detoxes from more addictive substances. PsychCentral also reports that only around 20 percent of patients experience what is known as SSRI discontinuation or withdrawal syndrome; of that number, only five percent experience symptoms that can be described as “severe.”5
As with other prescription drugs, it’s important to talk to your doctor before reducing or stopping your medication. A gradual weaning from the medication is necessary to reduce the chances of negative side effects.
Antidepressant Discontinuation Symptoms
People who have taken antidepressants for long periods of time can experience physical or psychological symptoms if they stop the drug or switch to another medication. This condition is known as “antidepressant discontinuation syndrome.” The Mayo Clinic notes that withdrawal symptoms are most common in people who have been taking antidepressants for six weeks or more. However, antidepressant discontinuation syndrome cannot be equated with addiction for several important reasons:
- Withdrawal from antidepressants does not cause cravings for the medication.
- Antidepressant users do not compulsively seek the drug.
- Antidepressant users usually don’t get caught in the cycle of repeated relapse.
- Using antidepressants typically does not cause negative effects on one’s personal life or health, such as job loss, accidental injuries, or financial difficulties.
After quitting an antidepressant, the brain can take time to adjust to the alterations in brain chemistry. To make the adjustment as smooth as possible, doctors often taper the dose of antidepressants, so that the user can gradually get used to the change. Without a medically supervised drug taper, the following side effects can occur:
- Return of depression
- Sleep disturbances
- Loss of appetite
- Muscle aches
- Sensory disturbances
- Involuntary movements (twitching, jerking)
WebMD points out that discontinuation symptoms are most often associated with short-acting antidepressants that remain in the system for longer periods of time. Examples of these drugs include citalopram (Celexa), escitalopram (Lexapro), duloxetine (Cymbalta), and venlafaxine (Effexor). However, discontinuing any antidepressant can cause unpleasant side effects, at least temporarily.
Avoiding Discontinuation Syndrome
Antidepressant discontinuation syndrome is fairly common among people who take these medications. American Family Physician states that although antidepressants are not habit-forming, up to 20 percent of people who stop taking them suddenly experience unpleasant side effects, usually within 72 hours after the last dose. In some cases, these side effects are unpleasant enough to cause the patient to miss work or other social obligations. For some people, discontinuation symptoms are so severe that they avoid taking any psychotropic medications again.
There are many reasons why someone might decide to stop taking an antidepressant. They may have decided that they don’t need the drug, or that the medication has too many unpleasant side effects, such as fatigue, weight gain, or loss of sex drive. The best way to avoid the symptoms of antidepressant discontinuation syndrome is to follow your doctor’s instructions and taper off the drug gradually. Taking a reduced dose of the medication will give the brain time to adjust to lower levels of the neurotransmitters that affect your moods.
Another way to avoid unpleasant side effects of antidepressant use is to take no more than the prescribed dose. Taking any prescription medication in excessive doses is dangerous, and antidepressants are no exception. Before you stop taking an antidepressant, talk with your doctor or a mental health professional to make sure this is the right decision for you. Be aware that if you stop taking antidepressants, you may experience a recurrence of depressive symptoms.
Comprehensive Depression and Drug Rehab Treatment
According to the National Institute on Mental Health, nearly seven percent of American adults (approximately 16 million) had an episode of major depression in 2012 alone. Depression is a serious psychiatric condition that can interfere with all aspects of a person’s life. It can also increase the risk of abusing illicit drugs, alcohol, or prescription medications. If you have questions about depression, addiction, or prescription medication abuse, call the toll-free number displayed on this page. Our admissions coordinators are here to help you get the information you need to create the life you want.
1 Nordqvist, Christian. “What Are Antidepressants? How Do Antidepressants Work?” Medical News Today, MediLexicon International, 15 Dec. 2015. Accessed 27 Oct. 2017.
2 “5 Surprising Uses for Antidepressants.” EverydayHealth.com. Accessed 27 Oct. 2017.
3 Mundell, E.J. “Antidepressant use jumps 65 percent in 15 years.” Chicagotribune.com, 17 Aug. 2017. Accessed 27 Oct. 2017.
4 “Selective serotonin reuptake inhibitors (SSRIs).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 June 2016. Accessed 27 Oct. 2017.
5 “Symptoms of Alcoholism.” Psych Central, 17 July 2016. Accessed 27 Oct. 2017.