Antidepressants are not additive. Antidepressants are among the most commonly used treatments for depression
Other treatments for depression include:
Talking Therapies, such as CBT (Cognitive Behavioural Therapy) and
Neuromodulation, such as TMS (Transcranial Magnetic Stimulation)
These two important treatment modalities will be discussed in future videos.
The vast majority of medications used to treat depression are not addictive and they do not cause dependence.
Let’s start by explaining what makes us say that a drug or a substance is additive or not.
There are certain characteristics that addictive drugs have, such as:
Compulsive and continuous use of the drug despite harmful consequences.
Tolerance, which simply means that the person needs to increase the dose of the medication or the drug they are taking in order to get the same effect as before.
Withdrawal symptoms, these are drug specific physical and psychological symptoms that the person would experience if they stop taking the drug or reduce the frequency of taking the drug.
Antidepressants do not have these characteristics; therefore, they are not addictive.
However, should not be confused by the fact that sometimes when patients stop taking antidepressants they start feeling depressed again.
Actually, this might an indication that the medication as working very well.
Let’s use an example here to make it more clear.
If a patient is suffering from diabetes and they need to continuously take insulin otherwise their diabetes would not be controlled, we do not say that this person is addicted to insulin, the same applies to antidepressants.
Sometimes when patients stop taking antidepressants abruptly they experience what we call discontinuation symptoms, this is different from withdrawal symptoms that the person would experience if they stop taking an addictive drug.
There are many things that we could do as psychiatrists to stop patients from experiencing these discontinuation symptoms, and I will discuss this in a separate video.
In summary, antidepressants are safe medications and they are not addictive. However, they should ideally be started and stopped under supervision of a psychiatrist or a GP.
Discussions around how long the patient should continue taking the medication should take place early on in the treatment journey, because we, as psychiatrists, we should not start antidepressants with the intention of keeping everyone on it forever.