Medications Used for Depression and Their Addiction Risks
As their name suggests, antidepressants are used to treat people who have depression. Many people who undergo a drug or alcohol addiction treatment program may be prescribed antidepressants to combat anxiety and depression that may occur during withdrawal. In other instances, antidepressants may be used during ongoing addiction treatment to address co-occurring mental health issues or to stabilize mood on a more long-term basis.
Categories of Antidepressants
There are several categories of antidepressants that are used to target specific neurochemicals in the brain. Depending on the range of symptoms a person presents with, they may be prescribed a certain type or combination of antidepressant. These categories of antidepressants are:
Selective serotonin reuptake inhibitors (SSRIs). The most common group of antidepressants are selective serotonin reuptake inhibitors (SSRIs). These work by treating serotonin imbalance in the brain. They decrease serotonin reuptake, which leaves more serotonin in the brain. Examples of SSRIs include:
- Citalopram (Celexa)
- Sertraline (Zoloft)
- Paroxetine (Paxil, Brisdelle, Pexeva)
- Escitalopram (Lexapro)
- Fluvoxamine (Luvox)
- Fluoxetine (Sarafem, Prozac)
Serotonin and norepinephrine reuptake inhibitors (SNRIs). These affect both serotonin and norepinephrine levels in the brain in order to reduce the symptoms of depression. They lessen the amount of serotonin and norepinephrine absorbed by the brain, which improves mood and helps to ease chronic pain. Some examples of SNRIs are:
- Levomilnacipran (Fetzima)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Khedezla, Pristiq)
- Venlafaxine (Effexor XR)
Tricyclic antidepressants (TCAs). These are a classification of the antidepressants that are used when other more common depression medications aren’t effective. Some examples of tricyclic antidepressants include:
- Clomipramine (Anafranil)
- Desipramine (Norpramin)
- Nortriptyline (Pamelor)
- Imipramine (Tofranil)
- Trimipramine (Surmontil)
Tetracyclic antidepressants. These are related to tricyclic antidepressants. Tetracyclic antidepressants have four cyclic rings that inhibit the reuptake of noradrenaline and serotonin. These drugs are used to treat both depression and anxiety by balancing neurotransmitters. Examples of tetracyclic drugs include:
- Maprotiline (Ludiomil)
- Mirtazapine (Remeron)
Dopamine reuptake inhibitors (DRIs). These prevent the reuptake of dopamine. Additionally, they usually prevent the reuptake of norepinephrine. Neurotransmitters dopamine and norepinephrine affect mood, and drugs in this classification treat both depression and seasonal affective disorder (SAD). They are also used to treat obesity, narcolepsy, and attention deficit hyperactivity disorder (ADHD). These drugs can sometimes help a person quit smoking. Bupropion (Wellbutrin) is an example of a DRI.
5-HT1A receptor antagonist. Prescription vilazodone (Viibyrd) balances serotonin and other neurotransmitter levels to treat depression. Vilazodone is rarely used as an initial treatment for depression. Generally, it’s used when other medications haven’t worked or when other medications have caused harmful side effects.
5-HT2 receptor antagonists. This medication changes chemicals in the brain in order to treat depression. Nefazodone is an example of this type of drug. Trazodone is another medication that works on the 5-HT2 receptor with a mechanism of action similar to nefazodone. Vortioxetine (Brintellix) is a 5-HT3 receptor antagonist that alters brain chemical activity to treat depression.
Monoamine oxidase inhibitors. These were the first types of antidepressant to be developed. They are not used as much today because of the dangerous side effects and drug interactions related to their use. MAOIs change the chemistry of the brain to treat depression by preventing the removal of the neurotransmitters serotonin, norepinephrine, and dopamine. They also have the potential to raise blood pressure to dangerously high levels. Some examples of MAOIs are:
- Tranylcypromine (Parnate)
- Isocarboxazid (Marplan)
- Phenelzine (Nardil)
- Selegiline (Emsam)
Do Antidepressant Medications Cure Depression?
Antidepressants don’t cure depression, but can be a helpful tool for managing symptoms of the condition. A study by the National Institute of Mental Health stated that out of 4,000 patients treated with an antidepressant, 41 percent of patients who were switched to a placebo relapsed, whereas only 18 percent who stayed on the antidepressant relapsed.
While antidepressants can be key to managing depression, they should be used in conjunction with therapy.
How Many People Take Antidepressants?
According to the American Psychological Association, as of 2017, 12.7% of people 12 and older had taken antidepressants in the past month. The use of antidepressants has increased over the years. Females are twice as likely as males to take an antidepressant medication.
Are Antidepressants Addictive?
Traditionally, antidepressants aren’t thought of as addictive substances; however, some degree of physical dependence can develop. As with any substance, antidepressants can lead to psychological dependence, particularly if they are abused.
It’s considered abuse if a person alters the form in which the medication is intended to be taken. For example, crushing antidepressants and snorting the resulting substance is abuse of the drug. These substances should also not be mixed with other substances of abuse, such as alcohol, opioids, or stimulants.
Co-Occurring Disorder Treatment in South Florida
If you are struggling with depression and addiction to drugs or alcohol, there is effective treatment that can help get you on the road to recovery. At Recovery First, our caring and knowledgable addiction treatment specialists have decades of experience treating co-occurring substance use and mental disorders.
To find out more information about our Hollywood, FL, residential rehab contact our helpful admissions navigators at . They can answer your questions about what to expect in rehab, how to start the admissions process, and tell you about your rehab payment options.
Many patients have insurance that covers substance use treatment. However, specific coverage varies by insurance plan. Complete our to find out if your insurance will cover some or all of treatment.