Frequently prescribed antidepressants include Zoloft, Lexapro, Paxil, Luvox, Prozac, and Cymbalta. The first two are deemed to be most effective against depression and have the fewest side effects, followed by Prozac, Paxil, Luvox, and Cymbalta. As helpful as antidepressants can be, antidepressant addiction can form if the patient never needed them to begin with. Many people are misdiagnosed with depression and prescribed these drugs – one study shows doctors misdiagnosed almost 66% of patients and prescribed antidepressants needlessly.
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What Are Antidepressants? Are They Addictive?
As the name suggests, antidepressants are used to treat depression – more specifically, its moderate to severe forms. The most common antidepressants are serotonin and norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs). SSRIs treat depression by altering the chemical balance of serotonin in the brain, which elevates mood. Similarly, SNRIs boost mood by altering norepinephrine and serotonin levels. This medication is sometimes prescribed to treat anxiety disorder and obsessive compulsive disorder (OCD), although this use may not always be legitimate. Is antidepressant addiction possible? It is still debated in medical circles. Many doctors will say these drugs aren’t addictive, but withdrawal symptoms of antidepressants have been reported, which would suggest dependence can form. Withdrawal symptoms include tremors, nausea, and more depression.
Antidepressant Abuse Potential
In 2005, over 118 million antidepressant prescriptions were given. Admittedly, the abuse potential of this medication is lower than that of stimulants or benzodiazepines, but it’s very much there. Misuse of antidepressants is a component of the exponentially growing rates of nonmedical prescription drug use, which are reaching epic proportions. A growing number of studies on PubMed, Medline, and PsycINFO are dedicated to antidepressant abuse. They consist largely of case reports. Most of these cases include individuals suffering from both a mood disorder and a substance use disorder. Most frequently, the motivation for non-medical use is to achieve a stimulant-like effect. Antidepressants can be abused in excessive doses, crushed and snorted or dissolved in water and injected. Negative consequences can include severe confusion, seizures, and psychosis depending on the antidepressant class and pharmacology.
The majority of patients who are prescribed this medication do not misuse it, but certain types of these drugs have significant abuse potential, especially monoamine oxidase inhibitors (MAOIs). Most cases of misuse of medications of this type were reported in the 1960s to 1990s. The most commonly abused antidepressant in the last decade is bupropion (Wellbutrin), which acts via dual inhibition of norepinephrine and dopamine reuptake. It is also one of the most commonly prescribed antidepressants.
When Does Misuse Become Dependence?
“What is drug addiction” may seem like a simple enough question, but its answer isn’t. While prescription drugs have been used to treat both medical and psychiatric illness in many patients suitably and effectively, rates of prescription drug abuse have reached epidemic levels. Despite the growing concern about abuse of prescription drugs, terms such as “abuse” and “nonmedical use” remain ambiguous, and are used interchangeably to describe a variety of motives and behaviors not intended by the doctor prescribing the drug. The National Survey on Drug Use and Health (NSDUH) defines nonmedical use of antidepressants as use without a prescription belonging to the patient or use motivated simply by the feeling or experience the drug causes.
Statistics: Dangers of Antidepressant Drug Abuse
There are many adverse consequences of antidepressant abuse despite the perception by some that these drugs are safer than prescription depressants and opioids and illegal drugs. In 2011, 88 965 emergency department visits involved nonmedical use of antidepressants. That same year, 228,366 people needed emergency medical treatment after a drug-related suicide attempt, and 95% of these involved OTCs or prescription drugs. Of the latter, antidepressants were the drug of choice in 20% of the cases. 38,329 people died from a drug overdose in the USA in 2014, and most of these cases involved pharmaceuticals. 3,889 of them, or 17.6%, overdosed on an antidepressant. These drugs contribute to morbidity according to Drug Abuse Warning Network data, especially considering that the medicine class encompasses stimulating, sedating, anxiolytic and other medications with a variety of pharmacologic properties, some of which may make addiction to antidepressants more likely. The National Epidemiologic Survey on Alcohol and Related Conditions-III shows that 40.3% of individuals suffering from major depressive disorder also have an alcohol use disorder (abuse or addiction) and 17.2% have a drug use disorder.
Comorbidity rates with bipolar disorder and substance use disorders are even higher. According to data of the National Comorbidity Survey Replication, the lifetime prevalence rate of substance use disorder and DSM-IV bipolar I disorder was 60.3%, with alcohol dependence being the most common with 56.3%.
Main and Side Effects of Antidepressants
The effects of these drugs can be quite similar to those of stimulants – people taking them experience a mood boost and become more sociable. Sometimes, there are feelings of euphoria, enhanced motivation, and dissociative effects including numbness and a distorted sense of time. Side effects can include nausea, weight gain and an increased appetite, loss of sexual desire, erectile dysfunction and other sexual problems, sleeplessness, fatigue and drowsiness, constipation, dry mouth, and blurred vision. Adverse side effects may be a sign the individual has been misdiagnosed with depression. What is more, people with an anxiety disorder will become very irritable or nervous when given an antidepressant.
Signs and Symptoms of Antidepressant Abuse
Antidepressant medication tends to work slowly over time to improve the user’s mood. People who are addicted to other substances may mix them in an attempt to get high. Patients who have been prescribed antidepressants for depression may abuse them or turn to other drugs for relief. Mood enhancers such as antidepressants don’t have immediate effects, however, which motivates the user to turn to other substances. General signs of abuse include changes in appetite, bloodshot eyes, an unkempt appearance, financial troubles, irregular sleeping patterns, and slurred speech. Drugs like Prozac and Zoloft may not be as dangerous as illegal drugs or depressants and opioids, but they don’t work for everyone, and there are dangers that come with taking these drugs. Even some doctors believe antidepressants are being prescribed too often. They find people could benefit from making a change in their life instead of taking drugs.
According to data of the Anxiety and Depression Association of America, 14.8 million Americans battle with depressive syndromes. 255 million antidepressant prescriptions were written in 2010. Critics maintain that these numbers are driven by pharmaceutical marketing campaigns. What is more, these drugs can take weeks to start working, and sometimes they never do. Often, a depressed patient will have to take four or five types of this medication before his doctor finds the best fit. People with severe depression often feel lied to when they learn relief won’t come as soon as they hoped.
Symptoms of Addiction to Antidepressants
Common symptoms include confusion and lack of emotion, a sore throat, shaking, seizures, paranoia, headaches, and hallucinations. Studies have shown that higher doses of antidepressants can lead to a higher risk of suicide in teens and individuals between 18 and 25 years of age. This risk moved the US Food and Drug Administration to change antidepressant labels to better warn users. What is more, anyone taking mood stabilizers faces an increased risk of suicide. Signs of severe depression and suicide plans include lack of plans for the future, inexplicable actions like making a will at a relatively young age, giving away belongings, checking insurance plans, experiencing dramatic mood swings, and adopting a negative outlook on life that is decidedly out of character, including notions about the hopelessness or meaninglessness of life. Increased alcohol or drug abuse, sleeplessness or oversleeping, loss of interest in things that the person used to find interesting and fun, and intense feelings of guilt or worthlessness may also indicate antidepressant addiction.
Antidepressants List: How Do Doctors Decide Which to Give?
A patient may hesitate to take antidepressant pills because he or she doesn’t know why the psychiatrist chose to prescribe those particular ones. So how do doctors decide which pill to give? Basically, they choose one out of a dozen with proven quality on the market. The top 12 antidepressant drugs have been listed in the medical journal The Lancet. Some psychiatrists disagree with the list, but it has given patients who’ve been subjected to the trial-and-error approach for too long some comfort. Typically, doctors will try different types of medication and wait to see how the patient will respond. Sometimes, they get the most suitable one right off the bat. Other times, luck isn’t on their side. Some people live with mild depression for years and never take medication, but when something bad happens to them, it can exacerbate their depression. It can become severe as a result, and normal day-to-day functioning becomes compromised. It’s definitely worth looking into the best medication on the market to avoid overmedication. In some cases, the side effects of an erroneously prescribed drug can be worse than the depression itself.
Common Antidepressants – How Do They Measure up?
Researchers compiled a ranking of 12 commonly prescribed antidepressants based on efficacy and acceptability. They understood efficacy to mean how likely patients would be to experience the effects they desired. Acceptability is taken to mean the likelihood that a person will keep taking the drug over the course of the study. Generally, it was assumed the drug’s side effects were too severe or there was another problem with it if a lot of patients dropped out of the study. Again, what works for one person may not work for another, and there are many other high-quality drugs on the market apart from these. The study conducted ranked the types of medication as follows.
Treatment for Antidepressant Abuse
When it comes to abuse and addiction to this type of medication, addiction treatment centers can play a pivotal role in the outcome. Patients with a history of substance abuse and individuals in controlled environments are most vulnerable and prone to abusing the medication. A professional will employ a wide variety of drug addiction treatment methods and raise the patient’s awareness of warning signs, including forms of abnormal behavior. A well-thought-out treatment plan should be developed when antidepressant misuse is detected, and it should include an aftercare plan as well. Flexibility is a key consideration as a patient’s treatment needs may change at a certain point. A lot of people seeking help for addiction are uncomfortable with the notion of their loved ones knowing they’re getting treatment. In light of the specific dangers antidepressant abuse can bring, such as an overdose, the treatment facility should be able to offer 24/7 support. Suicidal thoughts are a red flag among depressed patients and these need to be addressed with priority when and if reported. The patient might benefit from a continuing care group providing ongoing support to help him or her manage antidepressant use so the drug will help rather than inflict harm.