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Are Psychiatric Medications addictive?

are psychiatric medications addictive?

Yes and No. Most psychiatric drugs are not addictive. (Anti-depressants/Mood stabilizers/Antipsychotics)

Some classes of medications can be addictive and care is needed in prescription and taking them. (Benzodiazepines, Sleeping tablets)

  • What is addiction / or dependence to a medication?
  • Non addictive psychiatric medications
  • Potentially addictive psychiatric medications
  • How can I prevent becoming addicted to psychiatric medication?

What is addiction / or dependence to a medication?

Addiction on medication is when there is both psychological dependence and physiological dependence on the medication:

Physiological dependence

  • The body adjusts to the medication, and incorporates it into its normal functioning.
  • Tolerance develops to the medication, and people often increase the dose in order to get the same effect.
  • If the medication is stopped abruptly withdrawal symptoms can occur. Hence the need to wean off slowly.

Psychological dependence

  • This is characterized by cravings.
  • Abnormal emotional response to substances/medication e.g. lying , stealing
  • Disregard for how taking the substance affects your behaviour or relationships
  • Inability to stop taking the medication despite trying

Non addictive psychiatric medications

What are the signs/research showing that these psychiatric medications aren’t addictive?

  • You feel better at a certain dose, and are able to stay on that dose long term.
  • These drugs don’t activate the reward circuit in the brain like other substances do.
  • You are able to withdraw from them, and don’t get cravings for them. (You may experiences physical withdrawal or a relapse of symptoms though)
  • The typical signs of addiction are not present (i.e. damage to relationship due to overwhelming cravings resulting in theft / disregard for others)

If they aren’t addictive why are there withdrawal effects from them?

This is quite complicated. All of the psychiatric medications work at different receptors of different neurotransmitters (chemicals) in the brain and body. When you stop taking medication the neurotransmitters have to get back into a “new normal”- this can lead to a time limited period of withdrawal symptoms e.g. dizziness, headache, nausea.

This is why you need to withdraw slowly from psychiatric medication preferably with medical supervision. Withdrawing from some medications e.g. Venlor/Effexor can be worse than other medications. This is due to the way they are broken down in the body.

Potentially addictive psychiatric medications

The main group of medications are the anxiolytics/calming tablets or sedatives/Sleeping tablets e.g. Xanor, Rivotril, Ativan, Zolpidem or Zopiclone.

Table showing the pros and cons of using Anxiolytic / Sedating medications

Pros of Anxiolytics/SedativesCons Anxiolytics/Sedatives
Work quickly
Alleviate/ prevent panic attacks
Potentially addictive particularly in persons who are vulnerable* .These people may be more prone to developing an addiction.
Helps calm you while changing medications or waiting for the full effect of another medication Can cause sleepiness
Proven efficacy in treatment of anxiety disorder Can cause disturbances in memory and concentration – avoid driving or any other complex task
Can be taken as needed- daily dosing not needed Can with longer term use actually worsen depression
Sleeping tablets helps regain normal sleep patterns – which is necessary for the recovery of mood disorders.

They are usually only needed in the first few months after an episode until your mind recovers.

Long term use – recent research is showing that daily long term use can damage brain tissue and potentially lead to dementia

How do I know if I’m vulnerable to developing addiction?

  • Family history of addiction
  • Personal history of addiction (Either substances or actions(e.g. gambling))
  • Previous history of addiction to this class of medication

How can I prevent becoming addicted to psychiatric medication?

  • Be honest with yourself and your doctor.
  • Track in a dairy your daily use of these medications- and reason for taking them. Often patients take them habitually even if there is no need for the medication.
  • Only take what is prescribed, if you need more discuss it with your doctor.
  • Use it only when needed, sometimes they are initially needed daily, than can be used as needed.
  • Don’t doctor shop – and get multiple scripts of this class of this medication
  • If you are worried – some people find it helps giving them to a partner so that the medication use is ‘supervised’. In patients with history of addiction I usually advise this route.