Antidepressants Misuse and Addiction

How Are Antidepressants Misused?

An increase in feel-good neurotransmitters like serotonin can cause a reinforcing effect, though rare in antidepressants since this boost in mood is often subtle and feels natural. Misuse often happens outside prescribed doses⁵; for example, someone may take double or triple their prescribed dose (sometimes even 10x more) to achieve a ‘high’ similar to other drugs. This sensation only happens with high doses of certain antidepressants⁵, like bupropion.

Someone taking antidepressants for the sensation of being high may dissolve several pills in water and inject it using a syringe, take multiple pills orally, or crush them into a powder and snort it. To maintain their high dosing, they might request refills sooner than needed, take out prescriptions through multiple doctors, or request higher and higher doses without a demonstrated need.

Sadly, some people misuse antidepressants with the intent of taking their lives. In 2011 nearly every emergency room visit for a drug-induced suicide attempt came from prescribed medications; 20% of those overdoses involved antidepressants⁵, the highest percentage after prescribed opioids.

Can You Become Addicted to Antidepressants?

It’s very unlikely. One study answers this question⁶ with, “antidepressants do not have a clinically significant liability to cause addiction.” This is because most antidepressants don’t cause pleasurable or rewarding effects⁶, as addictive drugs like cocaine or alcohol do. And compulsive use of antidepressants, as seen in substance use disorders, is “exceptionally rare.”⁶

Antidepressants can cause withdrawal symptoms⁷, which raises an argument for their addictive potential since people may need to keep taking the substance to avoid withdrawals, similar to opioids and other addictive substances. Tapering plans can prevent uncomfortable withdrawals.

Factors Contributing to Antidepressant Misuse

Those who misuse antidepressants often have a history of substance use disorders⁵ or other comorbid conditions. And, as expected, people who misuse antidepressants typically have a mental health condition like depression. Since symptoms of depression can include suicidality⁸, these patients can be more likely to misuse their prescribed antidepressants in an overdose. 

Signs of Antidepressant Addiction

If you’re worried a loved one struggles with an antidepressant addiction, you can watch for signs and start an open-minded conversation. If you’re worried about your antidepressant use, you can bring your concerns to your doctor and look for signs of addiction in your own life.

Some key signs of an antidepressant addiction include:

• Taking more than their prescribed dose. For example, you may notice they take three pills when the prescription bottle only says to take one. 
• An inability to stop taking the pills, even if negative health, work, or relationship consequences arise.
• Spending excessive time and money to procure antidepressants. 

Treatment Options for Addiction

If you’re struggling with an antidepressant addiction or any drug or alcohol addiction, you have resources available for recovery. Treatment options broadly fall into 2 categories: inpatient and outpatient care.

Inpatient Care

Inpatient treatment includes treatment in a hospital (often for acute withdrawal needs or overdoses) or attending a residential rehab. At rehab, you’ll live with peers and receive treatment from clinical staff, who monitor your health and emotional needs around the clock. 

Each day often follows a structure, with time for therapy (group therapy, 1:1 sessions with your therapist, and family therapy), fun activities, peer meetings, and downtime. Rehabs last 28+ days, aiming to treat both mental and physical needs for comprehensive healing. You’ll also learn relapse prevention strategies and get connected with outpatient levels of care, if desired, to continue your healing journey.

Outpatient Care

In short, outpatient care is the treatment you attend without living at a treatment facility. You return home after treatment and have more flexibility to work, attend school, and meet family needs. Outpatient care could include

1. Day treatment, where you undergo therapeutic treatment and practice practical recovery skills for 5-7 days a week. Sessions often last 5-7 hours daily, making day treatment the most intensive version of outpatient care.
2. In intensive outpatient programs (IOPs), you attend treatment 3-4 days weekly for about 3 hours a day. These also offer therapy, peer support, and an encouraging and supportive recovery environment but with a less intensive schedule.
3. General outpatient can include 1-2 weekly group therapy sessions, lasting an hour or so each. 
4. Regular 1:1 therapy sessions with a therapist. You may see them once a week, once every two weeks, or at the cadence best fit to your recovery needs.

Help from Your Doctors

As medication prescribers, your primary care physician (PHP) and/or psychiatrist can also help you. They can ensure that, going forward, all antidepressant prescriptions are carefully considered and that you have a clear plan for how to take them without risking addiction.

For example, your doctor may only prescribe a week’s worth and set up regular appointments to check in and monitor your use. Or you can work out a plan with loved ones, like a spouse or parent, to keep your medications locked in a safe. This can also be a preventative measure for people struggling with suicidal thoughts or with a history of suicidal ideation and attempts.

At your appointment, you can ask questions like,

• “What is the addictive potential of this medication?”
• “Are there other medications with less addictive potential that I could try first?”
• “What signs should I look out for that mean this medication isn’t a good fit?”
• “What can I do if I start to feel like I’m relying on it too much?”

Find Treatment for Drug Misuse

Recovery exists for all types of addictions, including antidepressant addiction. Treatment can help you navigate the underlying causes of addiction and address emotional struggles with healthy coping strategies and new behaviors. 
You can use Recovery.com to find prescription drug treatment centers and see their insurance information, reviews, photos, and more.