Types of Antidepressants & Their Role In Addiction

Can You Get Addicted to Antidepressants?

There is limited medical evidence to suggest that antidepressants are typically addictive. An early study noted the absence of acute desirable effects make addiction “theoretically unlikely.” Tranylcypromine and amineptine were considered to possibly have addiction potential, but these drugs are not in common use anymore, and other antidepressants are generally considered nonaddictive.

With the above in mind, a survey of 1,829 New Zealanders had 27 percent report being addicted, with very few people claiming they were told about the possibility of withdrawal or dependence when being prescribed antidepressants. While it’s possible that a significant portion of individuals may be confusing physical dependence with withdrawal, this is still a significant number of people believing that they suffer from an addiction to substances generally considered to be nonaddictive by experts. 

More research into how addictive antidepressants may be is warranted.

Key Facts About Antidepressants & Addiction

• As many as 10 percent of women over 18 years old take antidepressants.
• Using antidepressants on a long-term basis as prescribed isn’t the same as having an addiction, as these medications can serve a variety of legitimate medical purposes.
• Well-researched information on the misuse and abuse of antidepressants is limited, but the topic is slowly gaining more attention over time.
• Misuse of antidepressants can be dangerous even if a person does not have an addiction.

The Different Types of Antidepressants

Antidepressants fall into distinct categories. These are some the most common types of antidepressants:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) work by inhibiting the reuptake of serotonin, a chemical that is essential to how we experience mood, causing more to build up in the brain than normal. SSRIs are usually the first type of antidepressant tried for a patient who might benefit from this type of medication, as they are associated with fewer side effects and less serious overdose risk than other antidepressants.

Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs)

Serotonin-noradrenaline reuptake inhibitors (SNRIs) were originally developed to replace SSRIs, although they didn’t fully live up to that potential. Working in a way that is similar to SSRIs, SNRIs can benefit some people more than SSRIs do. 

Noradrenaline and Specific Serotonergic Antidepressants (NASSAs)

Noradrenaline and specific serotonergic antidepressants (NASSAs) are a type of antidepressant that is commonly used for people who cannot use or don’t respond well to SSRIs. They can also be used as an alternative for people who experience certain sexual side effects sometimes associated with SSRIs, as these are less typical of NASSAs. 

One of the more notable downsides is that NASSAs are associated with drowsiness when a person first starts taking them, although this drowsiness usually lessens overtime.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are older than the other medications discussed and less commonly prescribed today due to more risks associated with their use. They are still sometimes used when alternatives don’t have the desired effect.

Of the medications on this list, TCAs have the most serious overdose risk. They are mostly used for especially severe depression or to treat certain other mental health conditions, such as obsessive-compulsive disorder (OCD).

Serotonin Antagonists and Reuptake Inhibitors (SARIs)

Serotonin antagonists and reuptake inhibitors (SARIs), which includes drugs like trazodone, are not usually the first choice of prescribers, but they are another alternative antidepressant that can be prescribed if the usual options are ineffective or cause serious side effects. SARIs are often used to help treat depression in the elderly.

Side effects associated with SARIs seem fairly rare, including symptoms such as somnolence, dizziness, gastrointestinal dysfunctions, and dry mouth.

Addiction vs. Dependence

While addiction to antidepressants may be uncommon, or at least that is the stance of most experts, it’s important to note that dependence on antidepressants is common. 

Physical dependence, which is often confused with addiction, is when a person’s brain adjusts to the regular use of a drug and may cause them to experience adverse symptoms if they then suddenly stop taking it. This experience, called withdrawal, can make quitting a drug difficult, but it isn’t the same as addiction, even if many people dealing with addiction have also become physically dependent on a drug.

Unlike dependence, addiction is a compulsion to misuse drugs even while one experiences and understands that there are unwanted consequences for that use. On a mental and emotional level, a person who is addicted struggles to stop taking a drug even if that use has had an obviously detrimental effect on their quality of life. They are unable to stop using the drug.

How Are Antidepressants Abused?

One study on antidepressant abuse, which examined a variety of case reports, found antidepressants were most commonly abused in a desire to experience a psychostimulant-like effect, meaning the user was trying to achieve a pleasurable or invigorating effect. This could be done through a variety of methods, including crushing up the medication to snort or inject it.

This type of misuse is most common in people who also had a history of suffering from substance use and/or mood disorders. The vast majority of people who take antidepressants do not misuse them.

Signs & Symptoms of Antidepressant Abuse

Antidepressant abuse is associated with several adverse effects, including seizures, confusion, and psychotic-like symptoms, but the specific symptoms of misuse can vary depending on the type of antidepressant a person is using.

Any use of antidepressants that is different from how they are intended to be used when prescribed is “abuse,” even if a person isn’t intentionally misusing their medication. 

If an antidepressant isn’t having the effect you need it to, talk to a doctor. A higher dose is not always the solution and may result in more issues rather than fewer.

The Dangers of Mixing Antidepressants With Other Drugs

Polydrug use, which occurs when multiple drugs are used together, should almost always be avoided unless you first confirm with a doctor that the drugs you intend to take are safe to mix. 

Opioids are commonly mixed with antidepressants, a mix that can increase your risk of a life-threatening overdose, which could be fatal or potentially cause permanent brain damage.

Even mixing antidepressants with other medications can sometimes be dangerous or change the way they affect you. For example, SSRIs can negatively interact with lithium, other antidepressants, certain asthma medications, and more. Again, never mix medication without first talking to a doctor.

Can You Overdose on Antidepressants?

Most antidepressants are toxic in high doses, and they are unfortunately often used for self-poisoning in suicide attempts. Even if a person doesn’t intentionally seek self-harm, misusing antidepressants has the potential to be life-threatening, especially if a person is taking TCAs and other older, less common antidepressants. 

Both doctors and patients who are taking antidepressants should be aware of the overdose risk associated with any antidepressant. If you have thoughts of self-harm, you should speak with your doctor immediately. Call 911 if you feel you are in immediate danger of hurting yourself.

Treatment Options

If you struggle with antidepressant use, addiction treatment may be appropriate. Even if your drug use doesn’t fully qualify as an addiction, an addiction treatment expert can work with you to form a treatment plan. 

The intensity of addiction treatment will vary depending on your needs. If you have been misusing multiple drugs, you’ll likely require more intensive treatment.  

Behavioral therapy is often recommended. Cognitive behavioral therapy (CBT) focuses on restructuring how you think about drugs and drug use, identifies why you use drugs, and helps you make positive changes in the way you think to better avoid drug misuse.

If you want to stop taking an antidepressant but have been experiencing withdrawal symptoms, a doctor (usually the one who prescribed the medication) can generally help you quit the medication with fewer symptoms. In some cases, they may monitor how you do without any medications. In other cases, they may safely switch you to a different antidepressant. 

It’s important to communicate with your doctor regularly regarding any symptoms you experience when stopping antidepressants or switching to a new medication.