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The Impact of Antidepressants on Substance Abuse Recovery

Depression and substance use disorders (SUD) can often coexist. In fact, nearly one-third of individuals who have major depressive disorder also have substance use disorder. While antidepressants can be a crucial tool in treating depression, they can also interact with certain substances and cause negative side effects. For these patients, careful consideration should be made when looking at treatment methods for substance abuse. We’ll take a closer look at how antidepressants work, any risks associated with taking them, and how they can impact recovery from substance abuse.

How Do Antidepressants Work?

Antidepressants typically work by increasing the levels of neurotransmitters in your brain. These neurotransmitters can include serotonin and norepinephrine – which are associated with emotion and mood. Studies show that antidepressants can also increase neuroplasticity. This means your brain can create new pathways and connections between neurons and brain cells.

How Long Does It Take For an Antidepressant To Work?

When you first start taking an antidepressant, your healthcare provider will likely prescribe a small dose and adjust the amount if needed. It may take a few weeks or several months before you notice the effect of the medication. Keep in mind that while antidepressants treat symptoms of depression, they don’t always treat the underlying cause of it. This makes other methods of treatment, like therapy, key in treating depression.

Types of Antidepressants

Each type of antidepressant affects the neurotransmitters in the brain in various ways. Take a look at the different classes of antidepressants below:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Serotonin is known for having a positive effect on emotion, mood, and sleep. SSRIs increase serotonin levels in the brain by inhibiting its reuptake or reabsorption. Developed in the 1970s, SSRIs tend to have fewer side effects than older antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work similarly to SSRIs by stopping the reuptake of both serotonin and norepinephrine. They are used to not only treat depression but are also sometimes used to treat anxiety and nerve disorders. SNRIs include desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor XR).

Tricyclic Antidepressants (TCAs)

TCAs were developed in the 1950s. They block the reabsorption of norepinephrine, serotonin, and acetylcholine into nerve cells. TCAs include amitriptyline, desipramine, doxepin, imipramine, and nortriptyline (Pamelor). Since they cause more side effects than newer antidepressants, TCAs aren’t prescribed as often today, yet they can be very effective.

Monoamine Oxidase Inhibitors (MAOIs)

Like TCAs, these are an older type of antidepressant that aren’t prescribed as often as their newer counterparts. This type of antidepressant can have severe side effects with foods that are high in an amino acid called tyramine. MAOIs stop monoamine oxidase (an enzyme) from breaking down monoamines. This makes more neurotransmitters available for mood regulation. MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate).

Atypical Antidepressants

The last type we’ll cover is “atypical antidepressants.” These still affect dopamine, norepinephrine, and serotonin levels in the brain, just in different ways. One example is bupropion (Wellbutrin), which blocks the reabsorption of dopamine. Bupropion can also be used as a smoking cessation aid.

Side Effects of Antidepressants

While every type of antidepressant affects each person differently, common side effects include:

  • Diarrhea
  • Drowsiness
  • Headache
  • Sexual dysfunction
  • Nausea
  • Upset stomach

Many side effects improve with time. However, if they don’t go away, you may want to talk with your healthcare provider about adjusting your dosage.

Withdrawal from Antidepressants

It’s possible to experience withdrawal symptoms if you abruptly stop taking your antidepressants. Antidepressant discontinuation syndrome can cause flu-like symptoms, insomnia, and nausea. To avoid these symptoms, work with your doctor before you stop taking your antidepressants. They’ll likely gradually decrease your dosage and closely monitor your progress.

Can You Overdose on an Antidepressant?

It’s possible to overdose on antidepressants if you take too many pills or take antidepressants that haven’t been prescribed to you. It’s also worth noting that you have a higher likelihood of overdose if the antidepressants are mixed with other substances, like alcohol or drugs (prescription or illicit).

Get the Addiction Help You Need

If you or a loved one is struggling with substance abuse, it’s important to get the help you need. At Brentwood Springs Detox programs, we offer compassionate detox services for individuals who are dependent on drugs and alcohol. Call (615) 560-7545 to talk with a member of our team and learn how we can help you break free from addiction.

Signs of an Antidepressant Overdose

If you’re taking your antidepressants as directed, you shouldn’t have a problem with overdosing, but it’s helpful to understand the signs. Mild signs of an antidepressant overdose include:

  • Blurred vision
  • Confusion
  • Dilated pupils
  • Drowsiness
  • Fever
  • Headache
  • High blood pressure
  • Nausea
  • Tremor
  • Vomiting

More severe signs of an antidepressant overdose include:

  • Cardiac arrest
  • Coma
  • Hallucinations
  • Low blood pressure
  • Rapid heartbeat
  • Seizures
  • Shaking
  • Trouble breathing

In the most severe cases, antidepressant overdose can lead to loss of life. Seek medical care immediately if you think you’re overdosing.

Antidepressant Overdose Treatment

Overdosing on antidepressants requires emergency treatment. Your doctor may remove the medication with a stomach pump or use activated charcoal to reduce the amount of medication being absorbed. Your doctor may also prescribe benzodiazepines to help reduce agitation.

Another potential complication of taking antidepressants is serotonin syndrome. This occurs when there is too much serotonin in the body. Your doctor may give you serotonin-blocking medication as treatment.

Alcohol and Antidepressants

Now that we’ve covered the risks of overdose, you may be wondering: Can you drink on antidepressants? It’s not advised to mix alcohol and antidepressants as the combination can worsen symptoms and sometimes lead to dangerous results. Some of the effects of drinking while on antidepressants include:

  • Increased symptoms of anxiety and depression
  • Worsened side effects of the antidepressant
  • Sleepiness
  • Impaired judgment and motor skills
  • Dangerous spike in blood pressure (specifically with MAOIs)

Ultimately, it’s important to use caution when considering mixing any type of antidepressant, such as an SSRI antidepressant, and alcohol. If you’re planning to drink, don’t stop taking your antidepressant. This is because being inconsistent in taking your prescribed antidepressant can have a negative effect on your mental health and cause your medication not to work as intended.

If you have concerns about drinking on antidepressants, it’s best to talk with your doctor about what is the safest antidepressant for you.

SSRIs and Alcohol Addiction Treatment

How do antidepressants affect an individual in treatment for alcohol use disorder? They may have an adverse effect during treatment for alcohol use disorders. Specifically, the Recovery Research Institute shared a study that looks at how the SSRI, Citalopram, affected individuals receiving treatment for alcohol use disorder.

Over the course of 12 weeks, one group of patients was given a placebo pill, while the other group was given Citalopram. The results? The patients taking Citalopram did not see improvement and actually made some symptoms worse.

For individuals who struggle with alcohol abuse who also take an SSRI, talk with your doctor about the safest antidepressant for you to take. Other antidepressants, like tricyclic, may be more effective in treating symptoms of depression if you also struggle with alcohol use disorder.

How Do Other Substances Interact?

It’s generally not advisable to mix antidepressants with other substances. Doing so can lessen the effectiveness of your antidepressants and increase the medication’s side effects. We’ll take a closer look at two prevalent substances and how they interact with antidepressants.

Weed and Antidepressants

Cannabis on its own can make you feel more relaxed and potentially reduce symptoms of chronic pain. But is it dangerous to mix with antidepressants? Medical News Today shares that cannabis can affect how your liver breaks down certain medications, including antidepressants. This can lead to elevated levels of the medication in your body, increasing your risk of side effects.

It’s important to be upfront about your marijuana use with your doctor when discussing antidepressant options, as different medications can interact differently.

Adderall and Antidepressants

According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), one in three adults who have attention-deficit/hyperactivity also have depression or have experienced a depressive episode. With the overlap in these conditions, you may be wondering how medication used to treat the two can interact.

When it comes to mixing Adderall and antidepressants, it’s defined as a moderate interaction. This means if you’re taking the two, you should only do so under the close watch of your doctor. The biggest risk in combining the two medications is serotonin syndrome, which occurs when there are dangerous levels of serotonin in your body.

Oftentimes, it’s a third drug introduced that can cause serotonin syndrome. For example, cold or cough medication that contains dextromethorphan can create a dangerous mix that causes serotonin syndrome. Follow your doctor’s prescribed dosage with Adderall and antidepressants and never hesitate to ask when introducing a third medication.

Antidepressants During Substance Abuse Recovery

For individuals who have co-occurring disorders, such as substance use disorder and a mental health condition, it’s often more effective to treat both at the same time rather than separately. This makes undergoing addiction treatment in a facility with medical supervision especially important.

Before you start your treatment program, you’ll need to share all of the other medications you are taking, including antidepressants. This will help your team tailor a treatment plan that is beneficial for you. Your team can also help address any adverse symptoms you may experience during detox. If you struggle with depression, behavioral therapy and holistic treatment options can give you additional tools for keeping your mind and body healthy after detox.

Comprehensive Detox Services Near Nashville, TN

If you struggle with substance abuse and depression, you are not alone. At Brentwood Springs Detox programs, we offer a wide range of detox services to help you break free from drug or alcohol addiction. Call (615) 560-7545 to speak with a member of our team and learn more about our personalized treatment approach.

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