Antidepressants: Effects, Abuse & Addiction

CDC reports that 13% of U.S. adults take antidepressants.

While antidepressants can be effective, it is possible to become dependent on antidepressants. Physical dependence on a substance will trigger withdrawal syndromes in its absence.

Those taking antidepressants may also self-medicate the symptoms of depression with alcohol or illicit drug. Research shows that alcohol is twice as likely as drugs to be abused by those with depression.

This guide highlights the effects of antidepressants, and also addresses the issues associated with antidepressant abuse and addiction.

What are Antidepressants?

Antidepressants are prescribed for the treatment of moderate and severe depression. 

The most common antidepressants are: 

• SSRIs (selective serotonin reuptake inhibitors): This class of antidepressant alters the chemical balance of a neurotransmitter called serotonin. Serotonin is associated with positive mood.
• SNRIs (serotonin and norepinephrine reuptake inhibitors): SNRIs can also boost mood by interacting with neurotransmitters in the brain. This class of antidepressant interacts with serotonin and norepinephrine.

Physicians may also prescribe antidepressants for the treatment of OCD (obsessive compulsive disorder) and GAD (generalized anxiety disorder). 

Most antidepressants are available as capsules or tablets to be taken orally. 

Antidepressants can be effective, although everyone responds to different types of antidepressants differently. Studies show that between 40% and 60% of those who took SSRIs or SNRIs for major depressive disorder reported some relief in symptoms within two months.

Common Antidepressants 

Some of the most prescribed antidepressants in the United States include: 

• Prozac (fluoxetine)
• Celexa (citalopram)
• Lexapro (escitalopram)
• Paxil (paroxetine)
• Zoloft (sertraline)
• Effexor (venlafaxine)

Next, a more complete list of commonly abuse antidepressants.

Antidepressant List

The most common types of antidepressants used to treat depression are: 

• SSRIs
• SNRIs
• Atypical antidepressants
• TCAs (tricyclic antidepressants)
• MAOIs (monoamine oxidase inhibitors)
• NaSSAs (noradrenaline and specific serotoninergic antidepressants)

SSRIs

SSRIs are a first-line treatment for depression. Selective serotonin reuptake inhibitors typically cause fewer side effects than other classes of antidepressants. 

These are the most common SSRIs: 

• Celexa (citalopram)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Zoloft (sertraline)

SNRIs

SNRIs may be effective if SNRIs are ineffective for alleviating the symptoms of depression. 

These are the most common SNRIs: 

• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)
• Pristiq (desvenlafaxine)

Atypical antidepressants

Atypical antidepressants include: 

• Desyrel (trazodone)
• Remeron (mirtazapine)
• Trintellix (vortioxetine)
• Viibryd (vilazodone)
• Forfivo XL or Wellbutrin (bupropion)

TCAs (tricyclic antidepressants)

TCAs (tricyclic antidepressants) like (Pamelor and Norpramin are associated with the presentation of more side effects than contemporary antidepressants. TCAs are not usually prescribed unless other antidepressants prove ineffective.

These are the most common TCAs:  

• Anafranil (clomipramine)
• Norpramin (desipramine)
• Sinequan (doxepin)
• Tofranil (imipramine)
• Pamelor (nortriptyline)
• Vivactil (protriptyline)
• Surmontil (trimipramine)
• Amoxapine
• Amitriptyline

MAOIs (monoamine oxidase inhibitors) 

MAOIs like Parnate, Nardil, and Marplan may be prescribed if other types of antidepressants do not reduce symptoms. This type of antidepressant cannot be combined with medications like SSRIs that increase serotonin. 

These are the most common MAOIs: 

• Nardil (phenelzine)
• Parnate (tranylcypromine)
• Marplan (isocarboxazid)
• Emsam or Eldepryl selegiline)

NaSSAs (noradrenaline and specific serotoninergic antidepressants)

This class of antidepressant may be used to treat major depressive disorder and anxiety disorders. 

These are the most common NaSSAs: 

• Tolvon (mianserin)
• Remeron, Avanza, or  Zispin (mirtazapine)

How Do Antidepressants Work?

Different antidepressants have different mechanisms of action, but all types of antidepressants affect neurotransmitters. Neurotransmitters are chemical messengers that brain cells use in order to communicate with each other. 

Research shows that antidepressant work in the following ways: 

• SSRIs: Reduce the amount of serotonin absorbed by the brain.
• SNRIs: Increase the levels of norepinephrine and serotonin in the brain.
• TCAs: Regulate amounts of serotonin and norepinephrine absorbed by the brain.
• MAOIs: Target monoamine oxidase (a brain enzyme), breaks down neurotransmitters like serotonin.

All antidepressants may stabilize mood in some people through the above mechanisms of action.

Antidepressant Side Effects

Different antidepressants have varying side effects, and not everyone will experience all listed side effects, if any. 

SSRI and SNRI antidepressants are associated with the following side effects: 

• Nausea
• Anxiety
• Headache
• Indigestion
• Sexual dysfunction

Symptoms should subside after two weeks. 

SNRIs may also increase blood pressure. 

TCA antidepressants are associated with the following side effects: 

• Insomnia
• Weight gain
• Tremors
• Dry mouth
• Rapid heartbeat
• Constipation

MAOI antidepressants are associated with the following side effects: 

• Constipation
• Drowsiness
• Dizziness
• Lightheadedness
• Dry mouth
• Nausea
• Diarrhea
• Sexual dysfunction
• Insomnia

MAOIs can also interact with SSRIs, potentially triggering serotonin syndrome. 

NaSSAs are associated with side effects similar to those of SSRI and SNRI antidepressants. They may also cause weight gain and daytime drowsiness.

Immediate Effects

The most reported immediate effects of antidepressants include: 

• Weight gain
• Nausea
• Reduced sex drive
• Tiredness
• Insomnia
• Blurred vision
• Dry mouth
• Dizziness
• Constipation
• Anxiety

Long-Term Effects

Research on the long term effects of antidepressants indicates that although depression reduced and quality of life increased, roughly one in three people who take antidepressants report still experiencing moderate to severe depression. 

The primary side effects include: 

• Sexual problems
• Weight gain
• Feeling emotionally numb
• Reduced positive feelings
• Feelings of addiction
• Caring less about others
• Suicidal ideation

Studies suggests that the risk of weight gain from antidepressants is much higher in women than men. 

Other research indicates a possible association between the use of antidepressants and blood sugar regulation problems like type 2 diabetes. 

Some people who take SSRI and SNRI antidepressants experience withdrawal symptoms upon discontinuing use of the medication. Symptoms may persist for two weeks and include: 

• Dizziness
• Anxiety
• Vivid dreams
• Nightmares
• Abdominal pain
• Flu-like symptoms

Are antidepressants addictive, then?

Antidepressants Addiction

Antidepressant addiction does not occur in the same way as addiction to alcohol or illicit drugs like cocaine and heroin. Even in the event of antidepressant abuse, this class of medication is not associated with the psychological cravings central to other addictions (substance use disorders). 

Physical dependence on antidepressants may develop, even in those who were misdiagnosed with depression. If you become dependent on antidepressants, you will experience withdrawal symptoms when you stop taking the medication.

Antidepressants may be abused in combination with alcohol. This can trigger severe complications, physical and mental, that include: 

• Worsened depression
• Increased anxiety
• Intense sedation
• Extremely high blood pressure
• Loss of coordination
• Overdose

It may take one month before antidepressants start working. This leads some people suffering from depression to self-medicate with drugs like marijuana or opioids. 

Even if you don’t think you need antidepressant rehab, it is inadvisable to suddenly stop taking antidepressants without consulting your prescribing physician.

Inpatient Antidepressant Rehab at California Detox

For the most structured and supportive treatment for antidepressant addiction, head to California Detox in Laguna Beach. 

If you have depression and a co-occurring addiction to alcohol, prescription medications, or illicit drugs, our dual diagnosis treatment program allows you to address both conditions at the same time at a luxury Orange County rehab. 

During inpatient treatment for antidepressant addiction at California Detox, you can access these science-based interventions and holistic treatments:

• Medication-assisted treatment
• Psychotherapy (CBT or DBT)
• Individual counseling
• Group therapy
• Family therapy
• Holistic therapies

We offer treatment programs at all levels of intensity at California Detox, so you may step down to some form of intensive outpatient treatment before transitioning back into daily living in Laguna Beach. Reach out to admissions today by calling 949.694.8305.