(CNN) – When Robert F. Kennedy Jr. answered questions about his stance About antidepressants At a recent U.S. Senate confirmation hearing before becoming a secretary to US Health and Human Services, he sparked a debate over whether drugs are as addictive as commonly abused drugs.
“People, including members of my family, know who have had far worse times than people get off heroin.” Kennedy said in the meantime. Hearing on January 29th Antidepressant drug class It is known as a selective serotonin reuptake inhibitor. Kennedy told committee members that he had been obsessed with heroin for 14 years when he was young and had recovered for 42 years.
Are antidepressants addictive? The short answer is no, says an expert who spoke to CNN.
They said there is a difference between addiction to drugs (addictive) and reliance on medications that treat mental health disorders.
The truth is that Kennedy appears to have reached during the hearing, which means that some people experience difficult withdrawal symptoms when they stop using antidepressants. There are several reasons, but it’s not because they’re obsessed with antidepressants, experts said.
Dr. Gale Salz, an associate professor of psychiatry at Weil Cornell Medical University in New York City, says how you communicate about drug therapy is not only important for accuracy, but also for the stigma that doesn’t prevent people from seeking help with mental health issues.
“What he said is true, but I think the context is important (it’s important),” said Dr. Joseph Whitt Dohring, psychiatrist and co-founder of Taperplinic, a private practice based primarily in Palm Desert, California, dedicated to the evaluation and treatment of patients taking psychotic medications or QUITIRIC medications.
“If you don’t know about it, you might hear it and suspect that everyone will have more trouble than leaving heroin,” Witt Doling said. “That’s not true. It’s just for people who are very vulnerable to withdrawal, and that’s a lot of them.”
Therefore, it is also important to acknowledge the diversity of experience with antidepressants when making treatment decisions, Witt-Doerring said.
CNN contacted the U.S. Department of Health and Human Services requesting comment from Kennedy.
What makes drugs addictive
Experts said why antidepressants are not the same as addictive drugs starting with neurochemical properties and their respective functions.
All addictive drugs — including heroin and other opioids, cocaine and alcohol — provide intense rewards mediated through the brain’s dopamine system, said Keith Humphreys, PhD, a professor in the Ester Ching Memorial Department of Psychiatry and Behavioral Sciences at Stanford University, California, who studies addiction. This reward is intensive compared to other rewards, and has evolved to be enjoyed by humans, such as eating on an empty stomach, cuddles a baby, getting warm when it gets cold, or having sex when it gets excited.
“Addictive drugs can produce big spikes in dopamine, and they’re much bigger than all of these important things,” Humphries said. “That’s why they can hijack their brains. The brains say, “Wow, this must have to be really important. It’s more important than eating or caring for my baby.”
“It’s a completely different mechanism from the mechanisms of antidepressants, and it’s not driven by dopamine at all,” Humphries said. The chemical system in which selective serotonin reuptake inhibitors (the most used form of antidepressants) select primarily targets is serotonin.
“They are spending more time serotonin spends on brain synapses,” he added. Antidepressants achieve this by inhibiting the reuptake or absorption of serotonin by the synaptic nerve terminals that secrete it.
“And that, frankly, for less understood reasons — it helps a lot of people get better at their moods and anxiety,” Humphries said.
Antidepressants do not reward or give to people above the world. They help most people feel more stable. Thus, drugs are “purely therapeutic,” said Dr. Ragy Girgis, professor of clinical psychiatry at Columbia University in New York City. “They don’t have the possibility of real abuse. People don’t long for them.”
The addictive nature, and therefore craving, indicates another important distinction between antidepressants and antidepressant use.
The former “results in recurring involvement in drug search and use despite the outcome,” Humphries said. This comes with the feeling that you can’t control consumption. These emotions consume a huge amount of brain space, making people obsessively think about when they get their next hit, when they use it, how effective it is, and what to do when the highs go away.
That reward-seeking behavior, and the health issues that medicines can cause, can interfere with functioning at work, at home or at the time they destroy their lives, experts said. Also, given the tendency for drugs to be resistant to the brain that grows over time, people can use more and more quantities to reach the same highs they first experienced.
People can experience less rewards from natural experiences such as eating or having sex. All of these patterns are why addiction is known as clinically Substance use disorders.
Antidepressants, on the other hand, can help many people to improve their lives more consistently and overcome substance use disorders.
When people are experiencing withdrawal from drugs, symptoms can generally include symptoms. Symptoms include agitating, diarrhea, nausea, sweating, cold, stomach cramps, muscle pain, trembling, appetite changes, sweating, fatigue, depression, vomiting, seizures and intense cravings. Death due to withdrawal from related seizures or heart failure is also possible. Especially if someone suddenly stops taking the medication.
What antidepressant withdrawals say about drugs
So, if antidepressants are not addictive, why do some people have a hard time getting off them?
According to Humphries, there is a difference between addiction and addiction. All dependence means that the body somehow regulates it to a chemical that person has repeatedly ingested. People can experience withdrawal from the various things they consume, even if it is not a drug.
Antidepressants that don’t reabsorb serotonin in your brain will help raise chemical levels, Salz said. In that setting, some of the brain’s serotonin-producing receptors may be reduced. When you quit your medication, you can ideally return to normal amounts of receptors, but your brain may need time to regulate it. If your brain is not adjusting at the same rate as you are reducing your drug intake, it can lead to withdrawal symptoms such as dizziness, headache, nausea, insomnia, and irritating.
Most people taking antidepressants do not experience withdrawal symptoms when they quit their medication, experts said. But the amount to do that starts at 15% Research in 2024to 33%, Humphreys said.
One of the confusing symptoms is what many patients call “brain zap.” This feels like an electric shock moving over the spine and the brain, Girgis and Saltz said. Symptoms usually last from weeks to six months.
However, there are also hundreds of thousands of people who have suffered from what they call long-term withdrawals over the years or decades. Some of these people end up in acute withdrawal with ear cries, photosensitivity, digestive problems, severe anxiety and cognitive impairment.
“The symptoms going forward are very extreme and multiple people have taken their lives because they can drive people to suicide,” Witt Doling said.
Otherwise, you cannot die from withdrawal of antidepressant drugs, other experts said.
Some of those experiencing such symptoms have been mobilized and lead the UK National Health Service to add “long-term withdrawal” to its database of official medical terminology in 2023. As a result, doctors can record patients experiencing it and better collect information about symptoms and treatment. The NHS has also established a challenging clinic to help patients safely stop antidepressants.
Why some people experience withdrawals, while others are not unknown, there are some solid predictors, experts said. All levels of withdrawal occur when a person who has been taking antidepressants for at least several months suddenly or quickly stops. It is too common for patients to decide they don’t want to take medication and do so without talking to their doctor. The dosage of the medication was also important.
However, providers also regularly experience patients too fast within just one to three months, Witt-Doerring said. Some people may be fine with this method depending on how long you are taking the medication, but Witt-Doerring thinks it’s best to gradually tapere off for more than 9-18 months.
Also, there may be genetic or biological factors, but people will be very sensitive, which is unpredictable, Witt-Doerring said. However, he added that most people can take off their antidepressants without any problems if they are done correctly.
Saltz said he “don’t argue with RFK Jr. or anyone else,” but quitting antidepressants is always the perfect experience, but “comparing it with illicit drug use and withdrawal isn’t about physiological, psychological or summing these two things about their impact on your life and happiness.”
If you are worried about taking antidepressants because of worries about what will happen if you decide to quit them later, “we don’t know if you’ll benefit without trying, and there’s not much risk to trying,” Humphries said. “Depression is a rotten experience.”
He added that it is true that antidepressants don’t help everyone, or that the first thing you try may not work for you. Be patient and beware of side effects that you can share with your healthcare professionals.
“The reality is, for some people, these are life-saving medicines. They literally try not to kill themselves or hurt themselves. Or maybe they don’t commit suicide, but they’ll destroy their lives,” Salz said.
If you are already taking antidepressants and want to stop, experts have said you are only doing so under the guidance of your prescriber.
CNN Wire
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