About Antidepressants

Antidepressant Classes

There are several different classes of antidepressants. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed psychiatric medication.
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin–norepinephrine reuptake inhibitors (SNRIs)
  • Atypical Antidepressants
  • Serotonin Modulators
  • Tricyclic Antidepressants (TCAs)
  • Monoamine Oxidase Inhibitors (MAOIs)
  • NMDA Antagonists
Commonly Prescribed Antidepressants
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Addiction Vs. Physical Dependence

Many dismiss the challenges of stopping antidepressants because they aren't "addictive". However, addiction is often conflated with physical dependence.

Addiction and physical dependence can occur simultaneously, but they are two distinct concepts. While physical dependence involves the body adapting to the presence of a drug, addiction involves compulsive drug use despite harmful consequences. Antidepressants are not addictive, but they can lead to physical dependence.

Addiction
  • Compulsive behavior, where the person continues using the substance despite obvious harmful consequences.
  • Interferes with responsibilities (work, relationships, etc.) and day-to-day activities.
  • Intense psychological cravings or urges to use the substance, which may dominate thought processes.
Physical Dependence
  • The brain and body adapt to the presence of the drug, altering its normal functioning to maintain balance (homeostasis).
  • Over time, the body becomes accustomed to the substance, requiring higher doses to achieve the same effect.
  • Physical and psychological symptoms occur when the substance is reduced or stopped.

What To Know Before Starting Antidepressants

Fundamentals

Risks

  • Post-SSRI Sexual Dysfunction 
  • “Bipolar Activation”
  • Akathisia
  • Suicide
  • Functional Brain Changes
  • Physical Dependence
  •  Interdose Withdrawal
  • Tolerance (“Poop Out”)
  • Polypharmacy
  • Long-Term Outcomes

What To Know Before Stopping Antidepressants

Fundamentals

  • “Discontinuation Syndrome”
  • Hyperbolic Occupancy and Tapering
  • Support Forums
  • The Medical Gap in Tapering Education
  • The Maudsley Deprescribing Guidelines
  • Tapering Help

Risks

  • Post-SSRI Sexual Dysfunction
  •  Akathisia
  • Suicide
  • Functional Brain Injury
  • Antidepressant Withdrawal
  • Misdiagnosis
  • Antidepressant Withdrawal Symptoms

Commonly prescribed antidepressants include Sertraline (Zoloft), Escitalopram (Lexapro), Bupropion (Wellbutrin), Trazodone, Fluoxetine (Prozac), Duloxetine (Cymbalta), Citalopram (Celexa), Venlafaxine (Effexor). A complete list can be found here. 

There is no antidepressant that is universally "safe" for everyone. All antidepressants carry the potential for withdrawal symptoms, adverse effects and outcomes. While some medications may appear to have fewer reported side effects or a milder withdrawal profile, individual responses vary greatly. What’s tolerable or effective for one person may cause significant problems for another.

The safest place to start is by learning about tapering — the gradual reduction of your dose over time — and understanding that withdrawal symptoms are common, especially if the medication is stopped too quickly. Review our tapering resources to better understand safe tapering methods.