Doctors do not consider antidepressants to be addictive. However, people may experience negative side effects when they stop taking them.

Antidepressants may reduce symptoms of depression. Some have approval from the Food and Drug Administration (FDA) to treat social phobia, post-traumatic stress disorder, panic disorder, and obsessive-compulsive disorder.

However, antidepressants do not cause addiction. However, if people take them for long enough, the body can become used to them so that they experience withdrawal when they stop. Individuals can often experience negative symptoms when they stop taking them, especially if they do so abruptly. This is similar to physical dependence, but it is different from addiction.

Read more to learn about whether antidepressants can be addictive, how they work, and whether people experiencing substance misuse should take them.

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According to the National Institute of Mental Health, antidepressants are not addictive.

However, if a person suddenly stops taking their prescribed antidepressants, they may experience unwanted effects. According to the National Alliance on Mental Illness (NAMI), up to 80% of people who abruptly stop taking them or reduce their dosage too quickly experience discontinuation syndrome or withdrawal symptoms. These typically develop within a few days of stopping the medication and may persist for weeks.

NAMI breaks the symptoms of withdrawal of discontinuation syndrome into several categories:

  • mood-related symptoms, such as agitation, low mood, aggression, panic attacks, mood changes, and anxiety
  • somatic symptoms, such as unexplained fatigue or sweating, flu-like symptoms, dizziness, and headaches
  • sleep-related symptoms, such as insomnia, excessive nightmares, and daydreaming
  • digestive symptoms, such as nausea and vomiting, abdominal cramping, and diarrhea

Other symptoms that have associations with discontinuation syndrome and withdrawal include:

  • sensations that feel like jolts or zaps of electricity in the body or brain
  • cognitive problems
  • hallucinations
  • muscle tension or pain
  • tremors
  • vision problems
  • itchiness
  • ringing in the ears
  • taste changes
  • itchiness

To avoid experiencing these effects, the American Psychological Association recommends that people gradually reduce their dose of antidepressant medications over several weeks. They also need to do this under the guidance and supervision of a doctor.

There is also some evidence that individuals seem to develop progressive tolerance to antidepressants. This means that the same dose of a certain medication can become less effective over time, so a person may need to increase their dose or change medication.

Antidepressants work by acting on neurotransmitters, chemical messengers that carry information between neurons, or brain cells.

Depending on the type of antidepressant, these medications either increase the release or block the reabsorption of the neurotransmitters norepinephrine, serotonin, dopamine, or in some cases, a mixture of the three.

Learn more about how different types of antidepressants work.

Many people experience depression and substance misuse simultaneously, as around 32% of individuals with major depressive disorder also have substance misuse disorders. People are likely to have the best outcome if they receive simultaneous treatment for both conditions.

A 2019 study looked at the best treatment options for those with both depression and substance misuse disorders. It concluded that antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), were the recommended first-line treatment.

The study authors also recommended forms of psychotherapy in conjunction with antidepressants.

A 2021 review agreed with this multifaceted treatment approach. The authors stated there was evidence that a combination of medications and cognitive behavioral therapy could be useful in treating people with depression and alcohol use disorders (AUD). This means a doctor may prescribe SSRIs to treat the depression while also treating AUD.

These results mean that if a person is experiencing both conditions, their treatment will be most successful if they receive treatments for them simultaneously — likely with a combination of medication and therapy.

Antidepressants can interact with other medications, such as migraine medications, anti-inflammatory drugs, and some asthma medications.

Taking antidepressants with other psychotropic medications can cause negative interactions. For example, medications that affect serotonin levels can interact with other medications that also act on this chemical. For example, migraine medications or other antidepressants do this, increasing the risk of experiencing serotonin syndrome, which can lead to serious complications.

Some antidepressants can also negatively interact with other medications, such as:

  • nonsteroidal anti-inflammatory drugs
  • some asthma medications, such as theophylline
  • psychosis and schizophrenia medications, such as clozapine and pimozide
  • bipolar disorder and severe depression medications, such as lithium

Some antidepressants may also not be safe for people with certain medical conditions or other demographic factors, such as:

  • cardiovascular disease
  • seizure disorders
  • types of glaucoma
  • liver disease
  • kidney disease
  • type 1 or type 2 diabetes
  • bipolar mania
  • bleeding disorders
  • benign prostate enlargement
  • pregnancy
  • breastfeeding
  • being under the age of 18 years

People taking antidepressants should also avoid consuming alcohol, as it is a central nervous system depressant and can worsen symptoms of depression and cause excessive drowsiness and dizziness. Additionally, those taking antidepressants should avoid using cannabis and illegal substances such as cocaine, heroin, ketamine, and amphetamines.

Additionally, monoamine oxidase inhibitors, a class of antidepressants, can cause serious interactions with some foods, such as:

  • cured meats
  • sauerkraut
  • aged cheeses
  • fermented soy products, such as tofu, soy sauce, miso
  • wine
  • beer

Like all medications, antidepressants can cause side effects, and around 50% of people taking them will experience them. However, these usually appear in the first few weeks of taking them and taper off over time.

Side effects that have links to taking antidepressants include:

Less common but more severe side effects that have associations with taking antidepressants include:

  • heart issues
  • seizures
  • liver damage
  • suicidal thoughts or behaviors

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Taking antidepressants can also lead people to develop antidepressant-associated or antidepressant-induced mania or hypomania. These conditions occur in those who experience or have a predisposition to disorders such as bipolar disorder and depression.

According to a 2020 study, around 14% of people with bipolar disorder who take antidepressants experience antidepressant-associated mania within a few days of taking the medications.

A doctor should monitor people who start taking antidepressants, and individuals should seek medical attention as soon as possible if signs they develop signs of mania, such as:

  • insomnia
  • trouble listening to others or following conversations
  • pressured speech, or talking excessively
  • being very impulsive, making reckless decisions, or taking unusual risks
  • extreme irritability
  • excessive or unnecessary spending
  • reduced self-care
  • trouble focusing
  • hypersensitivity to external stimuli
  • extreme self-confidence

Antidepressant medications are not addictive, but the body becomes accustomed to them with prolonged use. If a person stops taking them suddenly, they can experience symptoms of withdrawal or antidepressant discontinuation syndrome.

In most cases, doctors recommend antidepressants for individuals experiencing both depression and substance use disorders.