Are Antidepressants Addictive?
Depression can be treated in different ways. You may have therapy sessions by a licensed mental health professional, antidepressant medications, or a combination of both, depending on the severity of your symptoms. For people with depression, one of the major concerns they have about antidepressant medications is their potential for addiction.
First, let’s try understand how antidepressants work.
What are Antidepressant Medications
Scientists feel that depression can be the result of imbalances in a group of brain chemicals called neurotransmitters. In depression, the volume of inhibitory neurotransmitters (that inhibit firing of nerve impulses) – especially Gamma amino Butyric acid, GABA – overwhelm the excitatory neurotransmitters such as Glutamate, Norepinephrine - a version of adrenaline - and serotonin. As a result, the brain feels ‘less excited and fatigued'.
What antidepressants do is to restore the balance of neurotransmitters in the brain, such that the excitatory neurotransmitters are increased to overwhelm the effect of the inhibitory chemicals.
Antidepressants are divided into several subclasses of drugs based on how they act in the brain.They include :
· Tricyclic antidepressants such as Amitriptyline, Imipramine, and Nortriptyline. These medicines work by increasing the levels of serotonin and Norepinephrine in the brain. They also block the actions of some inhibitory neurotransmitters in the brain.
· Monoamine Oxidase Inhibitors. These include Selegiline and Phenelzine. These medications act by preventing the breakdown of Serotonin, thereby increasing their levels in the brain.
· Serotonin Reuptake Inhibitors such as Fluoxetine and Sertraline act by preventing the reuptake of serotonin into brain cells, making them more available for impulse transmission in the brain.
· Serotonin and Noradrenaline reuptake inhibitors including Duloxetine and Venlafaxine act by preventing the absorption of serotonin and Norepinephrine in the body, making them available to transmit excitatory signals in the brain.
Are Antidepressants Addictive?
Drug addiction is characterized by the need to take higher doses of a drug to feel the same effect. The basis of addiction is the involvement and activation of the brain’s reward circuitry that is fueled by a neurotransmitter called dopamine. Activation of this system results in euphoria and other behavioral effects that drive the user to dependence on the drug.
Antidepressants do not activate this circuitry in the brain, so are not addictive.
Furthermore, you need not take higher doses of antidepressant medications to feel the same level of relief as their modes of action bypass this dopamine-charged system.
Potential Side Effects of Antidepressants.
Although antidepressants have no addictive potential, you should be aware of their potential side effects.
Generally, side effects of antidepressants begin after a few weeks of first use and gradually wear off as you continue them. Although the side effects you will experience depends on the class of antidepressants you use, common side effects include anxiety, nausea, and constipation.
Studies have also shown an increased risk of suicidal ideation and withdrawal symptoms especially in children and adolescents who use these medicines.
Because of this tendency to cause suicidal thoughts, the FDA recommends that all antidepressants carry a black box warning about this to alert users. Although this symptom may disappear after continuous use of the medicine, you may need to check with your doctor for treatment or a change of your medications.
Withdrawal symptoms may occur after you stop using an antidepressant, especially the serotonin reuptake inhibitors. But not to worry, these symptoms are not the like the typical withdrawal symptoms that occur with drugs of abuse. Common withdrawal symptoms of antidepressants include anxiety, dizziness, abdominal cramps, flu-like symptoms, and tingling sensations in the body.
You should also take note of drugs that can have potentially dangerous interactions with your antidepressant medicine. Drugs that also boost serotonin levels in the brain, such as other antidepressants, Sumatriptan, and the antibiotic Linezolid can cause a sudden serotonin surge in the body, which sends the body into a dangerous overdrive.
Effectiveness of Antidepressants
When you start using an antidepressant, you may not notice any remarkable improvement until after several weeks. This is because restoring the neurotransmitter balance in the brain takes some time.
Many users may experience significant relief from depressive symptoms after 3 months; however, you do not have to stop using it when you feel better. It is probably best to continue using the medication for at least 6 months after you start to experience relief of your symptoms. If you stop using the drug too early, your symptoms may return.