Antidepressant Addiction: Signs and Side Effects of Antidepressant Abuse

Antidepressants are prescription medications used to treat depression and other mental health conditions that are grouped into several classes. Most don’t produce an immediate “high” like opioids or stimulants. However, it’s still possible to misuse or develop a dependence on them. The risk of dependence increases with certain medications and use patterns.

Antidepressant misuse may involve taking higher doses than prescribed, using someone else’s medication or combining antidepressants with other substances. Some individuals take specific antidepressant medications for their stimulant-like effects.

This page provides an in-depth overview of antidepressant addiction (misuse), including side effects and withdrawal symptoms. It focuses solely on the health effects of antidepressants and the potential signs of addiction and doesn’t discuss rehab programs or other treatment options.

Antidepressants are grouped into several classes. The class an antidepressant gets grouped into depends on how it affects your brain chemistry and the neurotransmitters it targets, such as dopamine, serotonin or norepinephrine.

Classes of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Selective norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)
• Atypical antidepressants
• Monoamine oxidase inhibitors (MAOIs)

Some antidepressants are prescribed more often than others. Common antidepressants include:

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Paroxetine (Paxil)
• Venlafaxine (Effexor)
• Duloxetine (Cymbalta)
• Bupropion (Wellbutrin or Zyban)
• Mirtazapine (Remeron)
• Amitriptyline (Elavil)

Unfortunately, antidepressants have a street value and are often misused. You may have heard slang terms that refer to antidepressants. These slang terms can vary by region and drug type. For example, Wellbutrin misuse is often linked to several bupropion street names.

Slang terms for Wellbutrin include:

• Wellies
• Dubs
• Welbys
• Barnies
• Jailhouse coke

In 2023, more than 11% of American adults took prescription medications for depression, according to the Centers for Disease Control and Prevention. Antidepressants play an important role in helping people manage their mental health, but misuse goes far beyond using the medications for their therapeutic benefits.

Although laypeople use the term “antidepressant abuse,” healthcare professionals refer to these patterns of behavior as antidepressant misuse, which helps reduce the stigma surrounding mental health issues. Clinicians have also started using “substance use disorder” in place of drug addiction.

Misuse involves taking more medication than prescribed, taking a medication that isn’t prescribed for you or chasing the nonmedical effects of antidepressants. It’s also possible to develop a psychological reliance on them if you believe you can’t cope with stress, function normally or feel emotionally stable without them. Some antidepressants, such as bupropion, may produce stimulant-like effects when crushed, snorted or otherwise misused.

You might start out taking them as prescribed and develop a tolerance over time. Tolerance can cause people to take an escalating antidepressant dose without professional guidance. This counts as misuse of antidepressants, even though the goal is to manage worsening symptoms or feel something more than hopelessness, not to get high.

The effects of antidepressants are more pronounced when you combine prescription medications with other substances. For example, an individual might use antidepressants with cocaine, amphetamines or opioids. Mixing antidepressants with alcohol is especially dangerous.

Antidepressant abuse involves misusing a prescription drug in some way. This includes:

• Taking an antidepressant without medical guidance.
• Using higher doses of an antidepressant than prescribed.
• Combining antidepressants with other substances to enhance their nonmedical effects.
• Taking antidepressants for longer than directed.
• Using someone else’s antidepressant prescription.

When comparing antidepressant abuse vs. addiction, the main distinction is that addiction is characterized by compulsive use. You may crave antidepressants or continue using them despite experiencing harmful effects. However, addiction patterns can look different with antidepressants than they do with illegal drugs.

Problematic antidepressant use often takes on familiar patterns. For example, you might take extra pills when you’re feeling stressed or adjust your dosage without consulting a medical professional. Some people misuse antidepressants to boost their energy or experience stimulant-like effects.

Compulsive medication use may cause you to:

• Seek multiple prescribers
• Hide your misuse from loved ones
• Request refills earlier than you should
• Use alternate routes (e.g., snorting) for bupropion

In the past, healthcare professionals didn’t believe antidepressants could cause dependence, but that’s changed over the years. Now clinicians recognize that stopping antidepressant use can cause serious withdrawal symptoms. This indicates that the body has developed a physical dependence on the medication.

Dependence-like effects may occur as your body adapts to antidepressant use, resulting in antidepressant discontinuation syndrome (ADS) if you attempt to stop using these drugs. Some people refer to ADS as withdrawal, but the symptoms are very different from what happens during opioid withdrawal or withdrawal from another addictive substance.

Some people also develop psychological dependence on antidepressants. This may cause you to rely on antidepressants for emotional steadiness or live in fear that your symptoms will return if you stop taking them. You may also have a psychological dependence on them if you feel like you can’t function without medication.

The risk of discontinuation symptoms varies by drug, dose and duration. However, stopping them abruptly increases the likelihood that you’ll experience ADS.

Antidepressant misuse can affect your well-being in several ways. Some people display concerning behavioral changes, such as:

• Taking more medication than intended.
• Using escalating doses without consulting a healthcare professional.
• Hiding antidepressant use from friends and family members.
• Using someone else’s medication.
• Running out of antidepressant medications early.

Medication-seeking behavior has also been associated with antidepressant addiction and other types of substance abuse. You may pressure your healthcare providers to supply you with specific drugs or dosages, visit multiple prescribers or repeatedly request refills earlier than needed.

Some signs of misuse relate to how you behave when you’re using antidepressants. For example, crushing pills or snorting tablets may indicate that you’re chasing nonmedical effects. Misusing bupropion suggests stimulant-seeking behavior, which is also concerning.

Certain physical and cognitive signs also point to problematic antidepressant use:

• Agitation
• Insomnia
• Confusion
• Dizziness
• Mood swings
• Impaired judgment
• Unusual risk-taking

Finally, antidepressant misuse may cause you to engage in unsafe behaviors. One of the biggest red flags is mixing them with alcohol, sedatives or stimulants. It’s also dangerous to combine antidepressants with other serotonergic drugs, which are medications that boost serotonin levels or activity in the brain.

Antidepressant withdrawal doesn’t cause the same symptoms as opioid withdrawal or stimulant withdrawal. Instead, it causes a variety of antidepressant discontinuation symptoms, including:

• Dizziness
• Nausea
• Insomnia
• Sensory disturbances (“brain zaps”)
• Flu-like symptoms (e.g., headaches, fatigue, muscle aches)

The symptoms of antidepressant withdrawal typically begin within days of discontinuing use and may continue for several weeks. Depending on the medication you’re using and the amount of tapering you’re doing, your symptoms may last even longer.

Once you stop an antidepressant, your depression or anxiety symptoms may return. This is different from discontinuation syndrome. If you have severe mood changes or other safety concerns, seek professional guidance right away.

All types of antidepressants can cause similar side effects when they’re misused. These effects include nausea, headaches, sweating and sleep disturbances. You may also notice appetite changes, sexual side effects or emotional blunting, a feeling of mental numbness or detachment.

Some antidepressants have stimulant properties, so their side effects may include stimulant-like risks, especially at higher doses. Stimulants can cause anxiety, irritability, restlessness and agitation. You may also have difficulty sleeping.

Antidepressant misuse may also cause serious complications, such as:

• Serotonin syndrome. Serotonin syndrome is a drug reaction that occurs when high levels of serotonin build up in the body. Serotonin is one of the neurotransmitters responsible for sending messages through the nervous system. The risk of serotonin syndrome worsens when you take more than one serotonergic drug.
• Dangerous sedation. Mixing antidepressants with alcohol can cause dangerous levels of sedation, leading to impaired cognitive function, slower reaction times and confusion. Some people even experience low blood pressure or slowed breathing.
• Varying overdose risks. Each drug class has unique characteristics, so the risk of overdose depends on which antidepressant you’re misusing. For instance, a tricyclic antidepressant overdose can cause life-threatening heart complications or severe toxicity.

You should also be aware of the link between bupropion misuse and seizures. You’re more likely to have one if you’re taking high doses of bupropion or using high-risk routes (snorting, injecting).

Risk factors are characteristics, exposures or traits that make you more likely to develop a substance use disorder. One of the most common risk factors for antidepressant misuse is the presence of a mental health condition, such as severe depression, anxiety and bipolar disorder.

You may also misuse antidepressants if you have chronic stress, a history of trauma or a substance use disorder. For example, people with traumatic histories may use substances to cope with their emotional pain.

Behavioral Factors

Certain behaviors make it more likely that you’ll develop a dependence on antidepressants, including:

• Self-medicating
• Taking escalating doses without medical guidance
• Chasing stimulant-like effects
• Using medication to blunt your emotions

Substance Abuse History Factors

A prior history of drug abuse (misuse) also makes you more susceptible to antidepressant addiction. This includes misuse of opioids, stimulants, sedatives or alcohol.

Access Factors

In some cases, easy access to antidepressants contributes to their misuse. You may develop a dependence on antidepressants if you have a long-term prescription, find leftover pills in the medicine cabinet or share pills with someone in your home. Limited follow-up with healthcare providers also increases the risk of antidepressant addiction.

What makes antidepressant misuse different from cocaine or heroin misuse is that antidepressants are legal medications used to treat physical and mental health conditions. However, just because you have a prescription from your doctor doesn’t mean you can’t misuse antidepressants. Purposely deviating from the prescription instructions goes beyond treating a mental health condition.

Diagnosing antidepressant addiction starts with an evaluation of your usage patterns. Clinicians look for risky use, loss of control and continued use despite harm. Inability to function normally is also a warning sign of addiction.

An initial assessment should also include a review of your:

• Medication adherence (taking medications exactly as prescribed)
• Refill history
• Dose changes
• Non-oral misuse patterns

Some warning signs apply to multiple conditions, so a clinician needs to consider other diagnoses. For example, you may be dealing with medication side effects or antidepressant discontinuation syndrome instead of an addiction.

A full evaluation may also include screening for co-occurring substance use and other mental health conditions. Co-occurring disorders can influence each other, so it’s important to determine if you have more than one diagnosis.

Medication misuse isn’t a personal failure. It can develop over time, especially if you become tolerant to your prescribed medication.

Consider getting help if you notice any of these red flags:

• Escalating antidepressant doses
• Non-oral misuse (e.g., snorting or injecting)
• Severe mood changes
• Seizures
• Unsafe mixing of antidepressants with other substances
• Impairment at work, school or home

Help.org is a free and confidential resource for finding prescription medication addiction help that matches your needs, preferences and location.