Overview of Antidepressant Use and Abuse
- Antidepressants are prescription medications used to treat depression, anxiety and other mental health conditions.
- People may abuse antidepressants for their stimulant-like effects.
- Side effects of abusing antidepressants include seizures, cardiac arrest, hallucinations, irritability and aggression.
- Signs of an antidepressant addiction include continuing to use despite negative consequences, using in dangerous situations, taking larger amounts than intended and cravings.
- Antidepressant abuse is on the rise in incarcerated populations.
- It is also on the rise among teens, who may see prescription drugs as safer than street drugs.
What Are Antidepressants?
Antidepressants are medications commonly prescribed to treat a number of conditions including depression, anxiety and obsessive-compulsive disorder, among others.1
People can become addicted to antidepressants if they take them inappropriately and in higher doses than prescribed. It can be very difficult to overcome this condition without substance abuse treatment because severe and life-threatening withdrawal symptoms may occur when the person stops taking the drugs.
Antidepressants are not addictive or dangerous when taken as prescribed. They have helped millions struggling with a number of mental health issues. If you've been prescribed antidepressants, be sure to follow your doctor's instructions and to ask him or her if you have any questions.
- Selective serotonin reuptake inhibitors (SSRIs).
- Serotonin-norepinephrine reuptake inhibitors (SNRIs).
- Tricyclic antidepressants (TCAs).
- Monoamine oxidase inhibitors (MAOIs).
- Phenylpiperazine antidepressants.
- Tetracyclic antidepressants. 2
How They Affect the Brain
Paying for Recovery and Types of Rehab
How much you pay for a rehab program will depend on the type of program, its location, how much your insurance will cover and its features.
Inpatient programs, luxury programs and programs in nice locations, such as near the beach, tend to cost more.
Do you need to pay out of pocket or finance your treatment? The Substance Abuse and Mental Health Services Administration's helpline can direct you to low-cost rehab options in your area.
Types of Addiction Recovery Programs
Common types of recovery centers for antidepressant addiction are:
Outpatient rehab . These programs do not require you to live at the treatment facility but may not provide the level of care and supervision of an inpatient program.
Inpatient or residential rehab. These programs are more intensive and usually offer medically supervised detoxification, medical care, an individualized treatment plan and group and individual therapy.
12-step programs. These are free, peer-support programs where you support other people with substance abuse problems while working through the 12-step recovery program. Pills Anonymous helps people struggling with prescription drug abuse.
Dual diagnosis treatment facilities. These programs can help with any other issues you may be struggling with in addition to antidepressant addiction , such as depression or anxiety.
How Are They Used?
SSRI antidepressants, in particular, can disrupt the various functions that the serotonin neurotransmitter regulates and can cause a number of side effects.
Some antidepressants act as stimulants in the body and brain when abused. The short-term effects of heightened stimulation in the central nervous system include:
- Increased energy.
- Increased self-confidence.
Antidepressants have a variety of side effects, even when taken as prescribed. Some of these can include:
- Hallucinations. 12
- Cardiotoxicity (weakening of the heart muscle). 13
- Cardiac arrest.
- Hypoxia (lack of oxygen in the body). 13
- Seizures. 12
When antidepressants are abused above and beyond the prescribed dose, individuals can experience even more severe, if not life-threatening symptoms.
Most of the side effects may go away after addiction treatment. But some of the effects may last longer depending on how long the person abused the drug.
- Dry mouth.
- Decreased libido.
- Weight gain.2
Long-term side effects are more likely if someone begins abusing antidepressants in childhood or adolescence. Additionally, the risk of long-term effects increases when someone begins compulsive, problematic misuse of these drugs. Some of these effects include:3
- Worsening depression.
- Weight gain.
- Blurred vision.
- Sexual dysfunction.
- Dry mouth.
- Altered cognitive and social skills.
- Abnormal heart rhythm.
- Problems at school, work and/or interpersonally.
- Financial difficulties.
- Increased stress within personal or martial relationships.
- Poor work or school performance.
- Excessive absences from work or school.
Signs and Symptoms of Addiction
You may be suffering from an antidepressant addiction if you or a loved one has experienced 2 or more of the following symptoms over the course of year:
- Taking antidepressants in larger amounts than intended.
- Failed attempts to cut down use or to quit.
- Excessive amount of time spent obtaining, using and recovering from the effects of antidepressants.
- Intense craving to use antidepressants.
- A loss of interest in hobbies or attending social events.
- Continuous abuse despite negative consequences.
- Repeated use in physically dangerous situations, such as driving or operating machinery.
- Continued antidepressant abuse despite worsening physical and physiological symptoms.
- Needing a higher dose to experience an effect (antidepressant tolerance).
- Withdrawal: symptoms occur when antidepressant effects wear off, and antidepressants are taken to prevent or relieve withdrawal symptoms. 6
How Addictive Are Antidepressants?
As mentioned, those who try to abruptly stop taking antidepressants may suffer from withdrawal symptoms and the worsening of certain health problems.5 Many continue using the drugs to avoid withdrawal, which may lead to an antidepressant addiction.
Many antidepressants cause withdrawal symptoms if they are discontinued abruptly. These symptoms may occur within a few days to a few weeks after the person quits taking them.
The chance of experiencing withdrawal effects varies with each medication. Talk to your doctor about tapering off gradually or seek help from a treatment center if you feel you are suffering from an addiction to antidepressants.
- Upset stomach.
- Numbness or tingling.
- Flu-like symptoms.
- Decreased visual acuity.
How Many People Abuse Them?
Antidepressant abuse is on the rise in the incarcerated population due to the inaccessibility of illicit drugs and ability to get prescriptions from therapy sessions. Prisoners may hoard the antidepressants, crush them and snort them in larger quantities, or trade them for other contraband. Case studies have documented prisoners reporting hallucinations and seizures associated with abuse. 12
Additionally, antidepressant abuse appears to be growing in the adolescent population (see "Teen Antidepressant Abuse" section below).
Taking larger amounts of antidepressants than prescribed or combining them with alcohol, marijuana or other drugs can lead to an overdose.
Potential signs of an antidepressant overdose include the following. These types of symptoms can become life threatening within an hour of onset. If an overdose is suspected, call 911 or go to an emergency room immediately.
- A dry mouth and skin.
- Urinary retention.
- An abnormal heartbeat.
- Dangerously high blood pressure.
- Cardiac arrest.7, 8
Teen Antidepressant Abuse
Antidepressant abuse in teens is on the rise due to the stimulant-like qualities produced by high doses and the ease of accessibility. Additionally, many teens may see antidepressants as less risky because they are prescription medications. There have been reports of hospital visits associated with teen antidepressant overdose or abuse .
An antidepressant addiction is especially dangerous for teenagers because individuals under the age of 25 who take certain antidepressants are at increased risk of experiencing suicidal thoughts.3
A study conducted by the Food and Drug Administration involving more than 2,000 adolescents who were taking antidepressants showed that at least 4% of those who were prescribed this form of medication suffered from suicidal thoughts or attempts.10, 11
Risks for Teens
Specific risks of antidepressant abuse for teens include:
- Worsening depression.
- Suicidal thoughts.
- Dramatic behavioral changes.
- Impulsive behavior.
- Altered cognitive, social and emotional skills during adulthood.
- Panic attacks.
- Problems at school.
- Increased risk of drug addiction during adulthood.
- Heart damage.
- Heart attack.
Find Treatment for Addiction
. Takayanagi Y1, Spira AP, Bienvenu OJ, Hock RS, Carras MC, Eaton WW, Mojtabai R. (2015). Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study. J Clin Psychiatry 76(1):40-4.
. Anderson HD, Pace WD, Libby AM, West DR, Valuck RJ. (2012). Rates of 5 common antidepressant side effects among new adult and adolescent cases of depression: a retrospective US claims study. Clin Ther. 34(1):113-23.
. Rincon-Cortes M. (2014). Adolescent Prozac administration exerts antidepressant-like effects in adulthood by reducing ERK2 signaling in the VTA. J Neurosci. 34(20):6719-20.
. Evans EA, Sullivan MA. (2014). Abuse and misuse of antidepressant. Sub Abuse Rehab. 5:107-120.
. El-Mallakh RS, Gao Y, Jeannie Roberts R. (2011). Tardive dysphoria: the role of long term antidepressant use in-inducing chronic depression. Med Hypotheses 76(6):769-73.
. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
. Bailey B, Buckley NA, Amre DK. (2004). A meta-analysis of prognostic indicators to predict seizures, arrhythmias or death after tricyclic antidepressant overdose. J Toxicol Clin Toxicol. 42(6):877-88.
. McKenzie MS, McFarland BH. (2007). Trends in antidepressant overdoses. Pharmacoepidemiol Drug Saf. 16(5):513-23.
. Ansorge MS, Hen R, Gingrich JA. Neurodevelopmental origins of depressive disorders. Curr Opin Pharmacol. 7:8-17.
. U.S. Food and Drug Administration. (2013). Antidepressants in children, adolescents, and adults. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273
. Barry CL, Busch SH.(2010). News coverage of FDA warnings on pediatric antidepressant use and suicidality. Pediatrics 125(1):88-95.
. Reeves, R., & Ladner, M. (2013). Additional Evidence of the Abuse Potential of Bupropion. Journal of Clinical Psychopharmacology 33(4): 584-585. Available at: http://journals.lww.com/psychopharmacology/Citation/2013/08000/Additional_Evidence_of_the_Abuse_Potential_of.31.aspx
. McCormick, J. (2002). Recreational bupropion abuse in a teenager. British Journal of Clinical Pharmacology, 214-214. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874291/