Antidepressants Addiction and Abuse

Antidepressants can be helpful in treating depression. Serotonin Specific Reuptake Inhibitors (SSRI) pills and benzodiazepines are commonly prescribed by doctors for the treatment and management of depression and anxiety-related disorders. However, it’s been discovered that over time, people who use these substances tend to develop tolerance and have a high chance of abusing them.

If you are taking antidepressants, it is possible to become dependent without even realising it, since you probably use them every day. In this article, we discuss the dangers of abusing medicines such as Amitriptyline and Amoxapine, and how to get help if you or someone you know is struggling with dependence.

What are antidepressants?

Antidepressants are a class of prescription medicines approved by medical authorities for the treatment of anxiety and depression.

They usually work by delaying the speed at which the body reabsorbs serotonin. The longer this natural neurotransmitter remains in the bloodstream, the more pleasant (and less depressed) the patient feels. This is specifically how SSRIs work.

Unfortunately, it is tempting to want to feel this way most of the time, so some people use the medicine even when they don’t need it. This is considered abuse and could lead to drug dependence.

Other names for antidepressants

Antidepressants are classified into different categories. These include Tricyclic antidepressants (TCAs), Selective Serotonin Reuptake Inhibitors (SSRIs) and Monoamine Oxidase Inhibitors (MAOIs). Common brand names include:

  • Fluoxetine (Prozac)
  • Citalopram (Celexa)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
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What are antidepressants used for?

People who go through difficult experiences, such as witnessing the loss of a loved one or being the victim of a sexual assault may suffer from depression and anxiety. Antidepressants are a medically-assisted form of therapy, used to help them cope while they go through lifestyle changes or counselling.

Depression has also been linked to hereditary causes. It is not uncommon for doctors to prescribe drugs to patients with a history of depression in their family. In many cases, antidepressants alleviate the symptoms. They could also be used for obsessive compulsive disorders (OCD), manic-depressive disorders, neuropathic pain and social anxiety disorder.

What does it mean to be addicted to antidepressants?

When somebody is addicted to antidepressants (or any drug), it means they have formed a physical or psychological dependence. It becomes difficult for them to function normally without using the drug.

Dependence develops when the brain becomes accustomed to a drug, so much so that the recommended prescription is no longer as effective to the user. When this happens, they might increase the dosage of their own accord. If the drug then acts faster, they will maintain the new dose until tolerance leads to fixation.

A brain fixated on antidepressants cannot function without them, because certain neurological pathways and chemicals have been altered. Without the drugs, the brain will react negatively by triggering uncomfortable effects known as withdrawal symptoms. This is when you feel forced to seek and use the drug, thus forming the cycle known as addiction.

Risk factors for antidepressant addiction

There are many factors that could put you at risk of addiction. For some legitimate users, addiction may form when they take their medication regularly for a prolonged period. Those who deliberately abuse antidepressants could become dependent for the following reasons:

  • Genetics: If you have a parent or grandparent who suffers from addiction, the chances of developing one yourself is higher than someone without such a history.
  • Biological: A natural defect or accident in the brain’s pleasure pathway can trigger addiction-forming behaviour.
  • Environmental: People who live in highly stressful environments are more prone to addiction than those who don’t. High prevalence of the drug within such an environment is also a contributing factor.
  • Social: Age and peer pressure may force some people to use and abuse drugs.

Victims of trauma such as violent crimes, accidents, and even pregnancy trauma often rely on antidepressants to feel better. Those with a family history of depression and addiction may be more susceptible than those without one. If you live in a highly stressful environment or have recently experienced a personal tragedy, the chances of drug abuse will be high.

While depression can affect any age group, some demographics are more likely to be affected than others. For example, teens and seniors (who are experiencing a lifestyle transition) are more prone to depression and may subsequently abuse antidepressants.

How addictive are antidepressants?

Antidepressants are not categorised under the Misuse of Drugs Act, which means they are not as addictive as hard drugs like cocaine or heroin. If you are abusing antidepressants, you may not experience cravings like someone using cocaine, but you are still at risk of developing tolerance and becoming dependent.

While the subject of antidepressant addiction is still a relative one, research has shown that some people who suddenly stop taking these drugs develop withdrawal symptoms such as hand tremors, nausea and depression.

Addictive properties of antidepressants

Most antidepressant abuse is caused by someone increasing their dosage when they feel the medication isn’t working as it should. This means the individual has developed tolerance. Addiction may also form quickly when you use the drugs with substances like alcohol to intensify their effect.

Although you might not develop ‘physical’ dependence, it is certainly possible to become psychologically addicted to antidepressants.

Methods of antidepressant usage

Antidepressants are commonly available in pill and tablet form and are ingested orally. However, people who want to feel the effects instantly may crush the substance into powder and snort it. Others even inject the liquid form intravenously.

The way you ingest drugs determines how quickly dependence is formed. Snorting and injecting hastens tolerance and builds dependence faster than when you swallow a pill. If you know somebody who snorts their prescription medication, they are probably abusing it.

Spotting antidepressant abuse

Identifying signs of abuse early on can save you or a loved one from a life of ruin, because that is precisely what addiction does. If treatment is not provided on time, the consequences can be damaging to your health, relationships and general lifestyle.

How can you tell when someone is abusing antidepressants? Unlike many mood-improving medications, antidepressants don’t get you ‘high’ or cause cravings – at least not in the stereotypical way. However, people with depression are twice as likely to abuse other drugs.

Common signs of abuse include:

  • Bloodshot eyes
  • Diminished mood
  • Changes in appetite
  • Poor sleep patterns
  • Slurred speech

There are also behavioural changes that may occur. For example, an abuser may withdraw from family activities and friends. People with drug dependence also tend to ignore their school, work or family responsibilities. A definite sign of abuse is being unable to quit when you want to; this means you are no longer in control of your substance usage.

Other obvious signs include:

  • Taking more than the recommended dosage
  • Running out of pills earlier than usual
  • ‘Doctor shopping’ (visiting multiple doctors for extra supplies)
  • Seeking the drug through illegitimate means

If these signs are familiar, consult a professional for help. If you need to organise an intervention, please approach it with caution. Have some trusted family members or friends by your side or involve a crisis intervention specialist.

Antidepressant abuse: Signs and symptoms

People who use antidepressants frequently can develop psychological dependence, but many experts don’t describe it as addiction, because the symptoms vary from typical addictive symptoms. However, abusing antidepressants has the potential to interfere with your everyday life, making it just as serious as any other kind of drug abuse.

The symptoms of antidepressant abuse are both physical and psychological. Some are listed above, but the following also apply:

  • Constant state of calm/sedation (‘zombie-like’ demeanour)
  • Sudden mood changes
  • Reduced libido
  • Weight gain
  • Nausea
  • Headaches/migraine

Psychological effects include feelings of hopelessness without the drug, bouts of depression, paranoia and suicidal thoughts.

Health risks from addiction to antidepressants

Antidepressants generally come with a range of side effects that could be harmful if abused frequently. Some of the most common side effects include:

  • Dry mouth
  • Mild agitation
  • Lethargy

However, more serious side effects may include reduced libido, inability to orgasm, rashes, tics, diarrhoea and extreme lethargy. There is also the risk of Serotonin Syndrome.

Short-term effects of antidepressants

Abusing antidepressants can have instant effects. Abusers may often lack emotion, show mental confusion, or suffer from a sore throat, tremors, paranoia, sexual dysfunction, headaches and hallucinations. In the worst cases, people who overdose may experience seizures. If urgent medical attention is not provided, it could lead to a coma or even death.

Long-term effects of antidepressants

Research has shown that higher doses and long-term antidepressant abuse increases suicidal risk amongst teenagers and young adults aged 18 to 25. Suicidal thoughts are not restricted to antidepressant abuse alone, but also other addictive drugs. Common signs of suicidal thoughts and long-term drug abuse include:

  • Hopeless attitude to life
  • Mental confusion
  • Organ failure (lungs, heart, liver)
  • Insomnia
  • Strong cravings for drugs
  • Severe withdrawal symptoms

Long-term drug abuse has the potential to make recovery more complicated and painful. If you have been abusing antidepressants for several months, discuss your situation with a medical professional before you attempt to quit.

Withdrawal effects from antidepressants

If you recognise any of the signs listed above, you are probably affected in some way. It is advisable not to make any hasty decisions like quitting abruptly. This could be risky, especially if you are a long-term user. Instead, consult an addiction specialist first.

Withdrawal is the body’s reaction to suddenly quitting a drug upon which the brain has become dependent. Because of its extreme attachment to the chemical in question, the brain cannot function normally without it. The result is the manifestation of a series of physical and psychological symptoms.

Physical symptoms of withdrawal include:

  • Nausea
  • Uncontrollable seizures
  • Hand tremors
  • Dizziness
  • Headaches
  • Sweating

Psychological symptoms of withdrawal include:

  • Mental disorientation
  • Paranoia
  • Hallucinations
  • Feeling of dread
  • Suicidal thoughts

You may also experience a ‘rebound’ effect. This is the sudden return of the condition the medication was initially used to treat. In most cases, it is an acute feeling of depression.

Co-occurring disorders

A co-occurring disorder is a mental health condition that is triggered by substance addiction. In the case of antidepressants, most patients also suffer from anxiety. This makes treatment twice as complicated, because the physician will need to consider addressing the disorders separately.

Having co-occurring disorders may also be referred to as dual diagnosis. If a patient with depression develops anxiety due to a drug addiction, this is known as co-morbidity. This is a condition where one person suffers two (or more) disorders at the same time.

Other co-occurring disorders include:

  • Bipolar disorder
  • Schizophrenia
  • Panic disorder

People with mental health conditions are at a higher risk of combining drugs and alcohol.

Antidepressants addiction statistics

In 2016, the NHS prescribed 64.7 million units of antidepressants. That’s a 3.7 million unit increase on the previous year, indicating a significant rise in the number of individuals needing antidepressant medication.

The 64.7 million units prescribed cost the NHS an average of £4.12 for each medication. That is £266.6 million of its total £9.2 billion annual spend on all types of medication. Among this figure, teenagers still represent a significant concern for anti-depressant addiction.

Relationship between antidepressants and other substances

Antidepressants work by stimulating the central nervous system (CNS). Many addictive drugs either stimulate or depress the CNS. Unfortunately, people who abuse drugs tend to mix them with other substances such as alcohol.

Most drugs are metabolised in the liver, so there is a tendency for them to interact with each other. Drug interaction is when two or more different compounds combine and affect the functions of each other. In some cases, the consequences are dangerous.

For example, taking an antidepressant such as Elavil alongside alcohol (a depressant) will have antagonising effects on the body, since one is a CNS stimulant and the other is a depressant. Conversely, mixing antidepressants with another stimulant such as cocaine can send the body into overdrive. Overexcitement can cause you to experience fatigue or even overdose.

Antidepressant overdose explained

Contrary to what many people think, you can overdose on antidepressants. The risk is higher when you mix them with substances such as alcohol. Alcohol depresses the central nervous system and numbs any sensations, allowing you to take a higher dose of antidepressant medication. Some people believe that this intensifies the ‘high’.

Unfortunately, this can cause you to take unusually high doses of the drug. If the quantity of medication is too much for the body to metabolise, it will go into shock. At this point, physical symptoms will manifest such as seizures, headache, foaming in the mouth, elevated heartbeat and depressed respiration. If urgent medical attention is not received, you may fall into a coma or die.

If you see somebody overdosing on prescription medication, call for help immediately. Open the windows for ventilation and loosen any tight clothing.

What to do if you need help quitting

Are you struggling with substance abuse? It is often difficult to quit on your own. The first step is to involve a professional. Find a good rehab centre with physicians who specialise in antidepressant addiction. If you are also affected by a mental health condition such as anxiety disorder, it is advisable to visit a dual-diagnostic specialist.

A doctor should be able to gauge your level of addiction and recommend an inpatient or outpatient rehab programme. Next, they will prepare a recovery plan and start you off on a tapering formula. This should prepare you for withdrawal. Ensure you have a close family member or friend for support.


Frequently Asked Questions

What are antidepressants?

Antidepressants are prescription medications used to treat people suffering from depression or anxiety disorders.

How are antidepressants used?

Antidepressants come in pill form and may be ingested orally, according to a doctor’s prescription.

How do people abuse antidepressants?

People abuse antidepressants when they exceed the recommended dosage or if they take them without a doctor’s prescription.

Are antidepressants harmful?

When they are abused, antidepressants expose the user to various side-effects, including health risks such as Serotonin Syndrome.

What is antidepressant dependence?

When the brain develops a fixation to antidepressants, it will be unable to function normally without them. If you don’t use these drugs, your body will experience withdrawal. This condition is known as drug dependence.

How can I spot antidepressant addiction?

Common signs include frequent lethargic behaviour, withdrawal from regular activities, running out of prescription medications quicker than normal, mood swings, ‘doctor shopping’ and so on.

Where else can I find help?

You can see a doctor or visit your local Narcotics Anonymous centre.

Should my teen take antidepressants?

If it helps them feel better, yes. However, it is important to monitor the results closely for side-effects or signs of abuse. Consult a doctor immediately if you notice something unusual.

Sources

  • https://www.theguardian.com/society/2017/jun/29/nhs-prescribed-record-number-of-antidepressants-last-year
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