Are antidepressants psychologically or physiologically addictive? – Kind of – but not in the way that you think!
For many years, most of the medical community have held steadfast to the idea that antidepressants were not “addictive.” But many of those, not in the medical community or those with no personal experience of drug abuse or psychiatric illness, were convinced that those “happy” pills were subject to abuse. In fact, both were wrong. Antidepressants are not “abusable“, but they are sort of “addiciting“.
To be clear – antidepressants are not subject to abuse. They do not produce a “high” or anything like intoxication. There is no immediate reward for taking antidepressants; in fact, one of the most troublesome things about antidepressants is that they take several weeks to actually work.
However, there is a difference between “abusable” drugs and “addictive” drugs. Addiction is generally thought of as a psychological illness – in the way that marijuana and cocaine are psychologically addictive. There is little evidence that either drug is physiologically addictive. The body does not become dependent on the drug… the brain may – but not the body.
On the other hand, some medications are physiologically addictive – without being psychologically addictive. Hormones are an example of this. Once you start taking hormones (such as estrogen replacement), your body will adjust to the presence of the medication – and if suddenly discontinued, will not function normally. There are many other examples of this, but you get the point.
Drugs like heroin, alcohol, and tobacco are psychologically addictive – but they are also physiologically addictive. In addition to the brain “wanting” them, the body “needs” them to function normally. If you suddenly take away the heroin, a severe withdrawal syndrome will begin. If you suddenly take away alcohol – you may have seizures and a number of life-threatening conditions.
Prescription pain medications and anti-anxiety agents, when taken inappropriately can also be both psychologically and physiologically addictive – like heroin and alcohol. When taken as prescribed, they are often still physiologically addictive.
Back to the antidepressants.
Certainly, years ago, sudden withdrawal of prescription antidepressants was known to be dangerous. But, with the development of selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and many others, most people have believed that there was no chance of physical addiction, and there would be no withdrawal.
Over the years, I would hear about people who complained of “withdrawal” symptoms which I dismissed – like most people in the medical community. Many of these patients also had a myriad of complaints – generalized pain, foggy thinking, and other things that were considered to be indicative of a hypochondriac or chronic complainer. Turns out maybe I was wrong.
- Anxiety and irritability
- Depression and mood swings
- Light-headedness and dizziness
- Fatigue, headache and flu-like symptoms
- Electric shock sensations
- Loss of coordination, tremors and muscle spasms
- Nausea and vomiting
- Nightmares and difficulty sleeping
Most people don’t experience these – or have only a mild reaction. Unfortunately, even “tapering” down won’t make that much difference as the symptoms may take a long time to go away – but the withdrawal is real and shouldn’t be dismissed!