Antidepressants are frequently-used drugs that can address everything from bipolar disorder to depression. Of the population over 12 years of age, 12.7 percent has taken an antidepressant in the last month, and a quarter of those who use antidepressants have been on them for 10 years or more.
With the ability to help millions of people struggling with depression, PTSD and many other conditions, antidepressants can be lifesaving for those who use them. However, as with all drugs, antidepressants can be abused and treatment may be required for those who are dependent.
What Are Antidepressants?
“Antidepressant” is a blanket term that refers to several classes of drug most commonly prescribed for depression or other mental health challenges. Antidepressants come in many different forms, but all major varieties have grown in popularity over the last several decades, in part due to the influx of such drugs that have been released onto the market in recent years, as well as efforts to destigmatize mental health.
Antidepressants work by adjusting neurotransmitters within the brain to stabilize mood and emotion. By normalizing the processes for dopamine, for example, it’s possible to help patients to sleep better, feel better, have more energy and even improve focus.
What Kinds of Drugs Are Antidepressants?
As mentioned, antidepressants aren’t all the same. This category of medication actually refers to several different classes of drugs including:
- Selective Serotonin Reuptake Inhibitors (SSRIs): As the name implies, SSRIs block the reuptake of serotonin, a neurotransmitter responsible for many complex functions, including promoting cognition, memory, and learning, but most commonly associated with well-being and happiness. Depression is often believed to be connected to a lack of chemicals like serotonin, so increasing levels in the brain can be effective for many patients. SSRIs are referred to as inhibitors as this function does not extend to other neurotransmitters. Common examples of SSRIs include Lexapro, Prozac, and Zoloft.
- Tricyclic Antidepressants (TCAs): Tricyclic antidepressants, also referred to as cyclic antidepressants, are among the earliest forms of medication used to treat depression. As such, they are less common today due to the increased efficacy of other forms of antidepressants, like SSRIs. The functionality of TCAs is similar to that of other similar drugs, acting to regulate levels of serotonin and norepinephrine in the brain. Examples of TCAs include Norpramin and Pamelor.
- Atypical Antidepressants: Atypical antidepressants are drugs that do not fit into the more commonly accepted classes of antidepressants. They function in classes of their own and thus cannot be lumped into groups like SSRIs or MAOIs. Atypical antidepressants still act on neurotransmitters in the brain like serotonin, norepinephrine, and dopamine, but the mechanisms through which this accomplished can vary greatly. The most commonly used example of an atypical antidepressant is Wellbutrin.
- Monoamine Oxidase Inhibitors (MAOIs): MAOIs are antidepressants that inhibit the reuptake of monoamine oxidase, an enzyme that is responsible for removing neurotransmitters like norepinephrine, serotonin, and dopamine from the brain. While somewhat effective, MAOIs have fallen out of favor due to potential interference with other medications and mechanisms for physical health. Those who take MAOIs are encouraged to follow a restrictive diet to reduce the likelihood of high blood pressure. These drugs can also affect other neurotransmitters that control additional functions, causing potentially serious side effects. Doctors may have to customize or adjust care during medical procedures for patients taking MAOIs to avoid critical complications. As such, MAOIs are often the last choice in treating depression. Examples include Marplan and Nardil.
Antidepressants are not instantly effective, with most varieties requiring around six weeks for true progress. Antidepressants also don’t affect everyone in the same ways, so patients may need to try several different medications, or a combination of medications, to find a fit that alleviates symptoms of depression without triggering unpleasant side effects.
How Are Antidepressants Used?
Antidepressants are most commonly prescribed for depression but can be used for a number of different medical conditions. The effects of these kinds of medications on the brain can offer significant improvement in a wide range of illnesses and health issues.
SSRIs are the most commonly used class of antidepressants due to a proven efficacy in conjunction with moderate and tolerable side effects. SSRIs can be used to treat:
- Anxiety disorders
- Mood disorders
- Obsessive-compulsive disorder (OCD)
- Attention deficit hyperactivity disorder (ADHD)
- Menopausal symptoms
- Neuropathic pain
Tricyclic antidepressants may also be used to address some of these conditions, including depression, pain from fibromyalgia, chronic pain and anxiety. Some atypical antidepressants may have additional uses. Wellbutrin is also sold under the trade name Zyban as a smoking cessation aid, while Trazodone is also used to treat insomnia.
Abuse of Antidepressants
Antidepressants aren’t commonly associated with abuse or addiction, but the misuse of antidepressants is certainly possible. Substance use disorders aren’t limited to illicit drugs, and addiction can occur with chronic use of any substance including antidepressants. Getting high is also not a requirement of drug addiction.
Due to the ways in which antidepressants work on the brain, using these kinds of medications long-term can indeed create a dependence that makes ceasing use a long and dangerous process. This isn’t always problematic — many people who take antidepressants take them for decades to control disorders that cannot be addressed through other methods — but for those who do not intend antidepressant use to be permanent, breaking the habit can be truly challenging.
In some cases, patients will choose to increase their own doses in an effort to improve symptoms, creating additional challenges in addressing drug use and management. Even though it is impossible to get high off of antidepressants, some individuals, both with a valid prescription and without, do not understand this and attempt to take high doses in an effort to maximize sensation.
Withdrawal is also common with antidepressants, with side effects including:
- Vivid dreams
- Mood swings and irritability
- Muscle aches and chills
- ‘Brain zaps’, or electric shock sensations
- Returning symptoms of depression
To minimize this process, many physicians recommend a slow taper process. However, after long-term use, avoiding any ramifications is not always possible.
Treating Antidepressant Addiction
For those who are addicted to antidepressants, treatment is the best possible option. Due to the withdrawal process and challenging side effects, quitting these kinds of drugs can’t usually occur via a cold turkey method, so a highly controlled and monitored taper is imperative. At a licensed treatment facility, this process can be overseen by highly trained addiction medicine professionals and combined with therapy to ensure the best possible outcome.
If you or someone you love has abused antidepressants or is struggling to wean in an effective manner, a rehabilitation program offers the support and resources necessary to overcome dependency. At FHE Health, we have the care available to ensure safe and comfortable recovery.