Wednesday, April 8, 2009

Abuse of Antidepressant Drugs

During class today, one of my students presented an interesting question: what happens if you are not depressed, but you take an antidepressant (particularly an SSRI)? Would you still get a boost in mood?

I did not have a great answer for this question, since (unlike some other psychoactive medications) I hadn't heard any reports of abuse of antidepressants. Usually, if a drug can make you feel good, there's someone out there who will attempt to abuse it. After a little online sleuthing, the picture appears to look like this: some folks out there have been abusing antidepressants, but it seems to be mostly limited to those who already suffer from addictions and have run out of other options to get a "fix."

Consider this article on California jail inmates who have been faking mental illness to gain access to medication. Dated 4/6/09, the report indicates that prisoners had been falsely reporting symptoms in order to get doses of either Seroquel, an antipsychotic, or Wellbutrin, a popular antidepressant. Wellbutrin (bupropion) is NOT an SSRI, but rather a dopamine and norepinephrine reuptake inhibitor, and is often used in combination with SSRI's. Apparently, the prisoners who took it reported a speed-like effect. The article seems to suggest that the larger problem was with Seroquel (quetiapene), which produced a hypnotic-like effect in users who didn't really need it. The article also noted that the Santa Clara County Jail addressed the problem by substituting other antidepressants and antipsychotics in response to patient symptoms, and the problem has since subsided, though there were some interesting unintended consequences, notably an increase in depression among inmates (presumably previously masked by their drug use) and an incredible cost savings.

I was able to turn up one other article, this one on reported cases of abuse of SSRI's. Some limited reports of abuse have surfaced, though it appears the majority of abusers were attempting to use the SSRI's to replace some other addiction.

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