Antidepressants are not considered addictive.
If you use them for a prolonged time, you may develop a mild physical dependence on them. As a result, doctors often recommend tapering off them when stopping use.
An antidepressant is a medication designed to specifically treat clinical depression.
Antidepressant medications are used to address clinically significant issues with depression that occur as a result of being diagnosed with major depressive disorder or another depressive disorder.
They are not designed to be used for everyday ups and downs, disappointments, or normal variations in mood that everyone experiences.
Antidepressants are typically classified based on how they work (their mechanism of action). There are several different classes of antidepressant medications.
(SSRIs) include some of the best-known antidepressants like Prozac (fluoxetine). They specifically block the reuptake of the neurotransmitter serotonin. When the neurotransmitter is released into the system and performs its function, it is then reabsorbed back into the neuron, a process known as reuptake.
Newer classes of antidepressant medications like the serotonin and norepinephrine reuptake inhibitors (SNRIs) or the dopamine and norepinephrine reuptake inhibitors (DNRIs) work on those neurotransmitters specifically. Effexor (venlafaxine) is an example of an SNRI, and Wellbutrin (bupropion) is an example of an NDRI.
(MAOIs like Nardil [phenelzine]) and tricyclic antidepressants like Elavil (amitriptyline) work on several different neurotransmitters.
These drugs do not appear to affect the reuptake or breakdown of neurotransmitters, but they may actually stop some neurotransmitters from being released into the system. An example is Remeron (mirtazapine).
Many of the above medications are used for other purposes, such as to treat certain types of pain, control anxiety in certain types of psychological disorders, and for other reasons. However, these drugs were primarily developed to address clinically significant depression (the symptoms associated with a clinical diagnosis of major depressive disorder or some other type of mental health disorder that involves severe symptoms of depression).
Many different types of medications may have the effect of lessening depressive symptoms, including benzodiazepines like Valium (diazepam), stimulants like cocaine and methamphetamine, and the newly approved drug to treat depression ketamine (a dissociative hallucinogenic drug).
Many other substances may reduce feelings of depression, but they are not classified as antidepressant medications.
An addiction, or a substance use disorder, refers to a specific type of mental health disorder where a person repeatedly uses some type of drug for nonmedical reasons (to get high) and develops significant issues with functioning as a result.
The development of physical dependence (withdrawal symptoms) can be a sign that one has developed a substance use disorder, but physical dependence can also occur in people who use drugs for medical reasons who have no addiction issues. Antidepressants do not produce euphoria, a psychoactive high, or some other type of effect that drug abusers typically seek. Some people think that because they relieve depression, they make you feel giddy and happy, but this is not the way these drugs work.
Antidepressants have low addiction potential, even though some people may misuse them. Many people who use antidepressants for medical reasons for several weeks may develop a mild level of physical dependence on them.
Recently, the dissociative hallucinogenic drug ketamine was approved by the U.S. Food and Drug Administration to treat clinical depression. This approval does not formally classify ketamine as an antidepressant medication because it was developed for other purposes (primarily as an anesthetic).
Ketamine is also a major drug of abuse, known on the street as Special K, and its abuse can result in the development of a substance use disorder that can be particularly difficult to overcome.
The use of ketamine in the treatment of depression is reserved for individuals who do not respond to other methods of treatment. It is tightly controlled, and typically very short term. It involves very small doses of the drug administered by a licensed physician. At the current time, it is not designed to be prescribed for at-home use.
The withdrawal syndrome that may occur in some people who use antidepressants for more than a few weeks is antidepressant discontinuation syndrome (ADS).
Withdrawal from antidepressants is not generally considered to be dangerous. The symptoms often resemble the onset of influenza and may include increased anxiety, depression, and feelings of jitteriness or nervousness. If you abruptly stop your antidepressant medication, you may experience these mild withdrawal symptoms and believe your depression is returning or you are getting the flu.
The appearance of withdrawal symptoms as a result of suddenly stopping a medication that one has been using for medical reasons is not a sign of an addiction. Usually, your physician will slowly taper down the dose of the drug over several weeks and wean you off it to prevent these symptoms.
The instructions on the prescription containers of antidepressants specifically state that the medication should not be used in conjunction with alcohol. In most cases, using an antidepressant with alcohol leads to a diminished effect of the medication and exacerbation of side effects.
Monoamine oxidase inhibitors (MAOIs) make up the oldest class of antidepressant medications. These medications are not regularly prescribed because the other classes of antidepressants can address depressive symptoms as effectively and produce fewer side effects.
If you are taking an MAOI, do not consume products that contain significant amounts of tyramine, an amino acid. Tyramine interacts with MAOIs in a manner that can result in significantly increased blood pressure (a hypertensive crisis). This can lead to a heart attack or stroke.
Alcoholic beverages that contain high levels of tyramine include certain types of liqueurs, red wine, vermouth, Sherry, and many types of beer.
If you have used ketamine for the treatment of depression, you should not drink alcohol. You may experience significant confusion, psychosis, amnesia, and aggression.
Because ketamine is used only in very small amounts and for limited periods when it is prescribed to treat depression, the potential to develop chronic issues is limited; however, long-term use of ketamine in alcohol can produce significant organ damage, including brain damage.
The take-home message is that antidepressants are not considered to be addictive, although if you use them for more than a few weeks, you may develop a mild syndrome of physical dependence on them.
Physicians typically control withdrawal symptoms from antidepressants by slowly weaning you off the medication if you wish to stop taking it.
(2019) Comprehensive List of Antidepressants. RxList. Retrieved April 2019 from https://www.rxlist.com/the_comprehensive_list_of_antidepressants/drugs-condition.htm
(March 2019) Benzodiazepine Abuse. WebMD. Retrieved April 2019 from https://www.webmd.com/mental-health/addiction/benzodiazepine-abuse#1
(March 2019) FDA Approves Esketamine Nasal Spray For Hard-To-Treat Depression. NPR. Retrieved April 2019 from https://www.npr.org/sections/health-shots/2019/03/05/700509903/fda-clears-esketamine-nasal-spray-for-hard-to-treat-depression
(May 2017) Antidepressant discontinuation syndrome. CMAJ. Retrieved April 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449237/
(March 2019) Dietary Precautions While Taking MAOIs. Verywell Mind. Retrieved April 2019 from https://www.verywellmind.com/foods-to-avoid-when-taking-maois-4136871