Throughout the world, more than 300 million people have some form of depression, according to the World Health Organization. They also say this disorder is the most common cause of disability throughout the world.
Treating depression often involves antidepressant medication. Since these drugs act on the brain, it’s important to know if they have addictive properties.
Depression is classified as a type of mood disorder. It affects how a person thinks, feels, and handles their normal daily activities, such as eating, sleeping and working. For depression to be diagnosed, the symptoms of this disorder must last at least 14 days, according to the National Institute of Mental Health.
The symptoms of depression may include:
It is believed that depression is caused by a combination of biological, psychological, genetic, and environmental factors. There are different types of this disorder.
The simple answer is that the type of antidepressant determines its potential for addiction. Standard antidepressant drugs do not cause cravings, and people do not have to regularly increase the dose to achieve the same effect. This is what makes them not addictive.
However, there are medications used to treat depression that have been proven addictive. These include benzodiazepines, such as Xanax and Valium. These medications are not categorized as antidepressants, however. They are generally described as anti-anxiety medications. Addiction to benzodiazepines is likely to affect people who have a sleep disorder, anxiety disorder, or mood disorder.
One of the most commonly prescribed types of standard antidepressants is the selective serotonin reuptake inhibitor. Examples include citalopram, fluoxetine, sertraline, escitalopram, paroxetine, and vilazodone. These medicines work to increase how much serotonin is in the brain.
SSRI medications are not considered to be addictive, but abruptly stopping usage may cause withdrawal-like symptoms, according to the Mayo Clinic. These symptoms, listed below, might be referred to as discontinuation syndrome.
Addiction is defined as a chronic disease that causes someone to pathologically pursue their substance of choice, according to the American Society of Addiction Medicine. SSRI antidepressants do not have this effect on people.
Benzodiazepines do have this effect on people, so they are considered an addictive substance. For someone to be considered addicted to benzodiazepines, they must meet at least two of the following qualifications, according to information published by the American Journal of Psychiatry:
Someone might start abusing benzodiazepines after being prescribed this medicine for depression or another mental health disorder. Others might use them without having a prescription and become addicted. This type of drug has a sedative effect that calms anxiety and may aid sleep issues, such as insomnia. These effects may cause people to use more of the drug than is necessary.
As someone continues to use benzodiazepines, they can develop a tolerance. This means that they have to continue increasing their dose to achieve the desirable effects.
The majority of people will require help to overcome their addiction to benzodiazepine medicines.
No matter which antidepressant medication someone is taking, it is important to stop it the right way to ensure safety. Stopping properly also helps to ensure greater comfort after someone stops taking antidepressants.
No matter the type of antidepressant someone takes, the safe stoppage instructions are mostly the same. Withdrawal from antidepressants can occur since these medications alter neurotransmitter levels, according to Harvard Health Publishing.
The first step in coming off these medicines is to make a plan. This plan should be discussed with the prescribing doctor since they will ultimately set up the tapering schedule. It is ideal to space out dosage reductions every two to six weeks.
People should take their time with the process. If someone comes off antidepressants too quickly, it could cause their depression to return. The general recommendation is to reduce the dosage in 10 percent increments to reduce the risk of depression returning. This could also reduce the risk of withdrawal symptoms.
People might also consider other forms of therapy for their depression, such as talk therapy or support groups. Reducing stress, eating a healthy diet, sleeping well, and getting sufficient exercise can all be beneficial. These actions could aid with someone’s depression symptoms as well as their goal to stop antidepressant medications.
People should remain in close contact with their doctor. They should be open about any challenges they are having with stopping antidepressant medications. It is especially vital to report any psychological or physical symptoms, especially if they are getting worse. Getting support from nearby family and friends is also imperative.
If you have been taking anti-anxiety benzodiazepines in addition to antidepressants, and abusing the medications, it’s important to consult a doctor before attempting to stop use. Benzo withdrawal can be dangerous, so tapering is essential. Working with a facility that can also treat your depression is imperative.
People might first start with medical detox to help them safely stop taking benzodiazepines. This process can aid clients in reducing some of the symptoms of benzodiazepine withdrawal. According to research published in Addiction, these symptoms might include the following:
This research states that these symptoms make up a condition referred to as benzodiazepine withdrawal syndrome. The symptoms last an average of 10 to 14 days after someone stops taking benzodiazepine medications.
Doctors might recommend tapering to help people to get off benzodiazepines without significant withdrawal symptoms. This process may go on for up to six weeks.
Using tapering along with cognitive behavioral therapy for three months is shown to be effective for helping people to decrease benzodiazepine use, according to research published in the New England Journal of Medicine.
Cognitive behavioral therapy helps people to address the underlying reason for their substance use disorder. It also aids them in creating healthy coping strategies.
Other behavioral therapies that might be recommended include:
Ultimately, antidepressants are not considered to be addictive. Some anti-anxiety medications, such as Xanax or Valium, are addictive.
Regardless of the medication that you are taking, your doctor can set up a safe tapering schedule to help you wean off the medication. If you have been abusing any substances, addiction treatment is needed.
(March 2018) Depression. World Health Organization. Retrieved December 2018 from https://www.who.int/en/news-room/fact-sheets/detail/depression
Depression. National Institute of Mental Health. Retrieved December 2018 from https://www.nimh.nih.gov/health/topics/depression/index.shtml
(April 2015) Should I Be Worried About Antidepressant Addiction? Net Doctor. Retrieved December 2018 from https://www.netdoctor.co.uk/healthy-living/advice/a25829/are-antidepressants-addictive/
Benzodiazepine Addiction. UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior. Retrieved December 2018 from https://www.semel.ucla.edu/dual-diagnosis-program/Conditions_Treated/Benzodiazepine_Addictions
Selective Serotonin Reuptake Inhibitors (SSRIs). Mayo Clinic. Retrieved December 2018 from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
(November 1994) The Benzodiazepine Withdrawal Syndrome. Addiction. Retrieved December 2018 from https://www.ncbi.nlm.nih.gov/pubmed/7841856
(2017) Treatment of Benzodiazepine Dependence. New England Journal of Medicine. Retrieved December 2018 from https://medicinainternaelsalvador.com/wp-content/uploads/2017/04/tratando-la-dependencia-a-benzodiacepinas.pdf
(April 2011) Definition of Addiction. American Society of Addiction Medicine. Retrieved December 2018 from https://www.asam.org/resources/definition-of-addiction
(August 2014) DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale. American Journal of Psychiatry. Retrieved December 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/
(November 2010) Going Off Antidepressants. Harvard Health Publishing. Retrieved December 2018 from https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
Antidepressant Medication. Help Guide. Retrieved December 2018 from https://www.helpguide.org/articles/depression/antidepressant-medication.htm