What Are the Predominant Myths About SSRIs?: An examination and debunking

This post originally appeared here.

SSRIs can be life saving medications. They can alter the course of someone’s life by managing the often debilitating symptoms of anxiety and/or depression. They don’t work for everyone, and some people have to discontinue them due to adverse side effects, but for those for whom they work well and cause minimal side effects, they can be transformational. For some reason, there are a lot of myths floating around about SSRIs. Here is an attempt to debunk some of them. 

Myth: SSRIs are addictive.

Some people have posited that SSRIs are addictive, perhaps because they sometimes do have withdrawal symptoms if stopped suddenly. However, just because something has a withdrawal effect does not in any way mean it’s addictive. SSRIs do not activate the kind of pleasure pathways that are associated with addiction to drugs like heroin. All drugs of addiction–including alcohol, cocaine, and opioids like heroin and fentanyl–activate dopamine pathways in the brain that reinforce their use. SSRIs do not do this and that is why they do not produce a “high” or lead to cravings.here is thus no neurobiological mechanism by which SSRIs can be addictive. .  

Myth: SSRIs cause unbearable withdrawal. 

It is true that SSRIs can have significant  withdrawal symptoms, including dizziness, insomnia, nausea, and flu-like symptoms, especially when stopped suddenly. This is more often a problem with SSRIs that have what are called short-half lives, meaning that they are metabolized and eliminated from the body relatively quickly. These medications, like Paxil and Zoloft, must always be tapered slowly to minimize withdrawal symptoms. Medications with long half-lives, like Prozac, are much less likely to cause withdrawal symptoms when stopped. Slow tapering of antidepressants is part of routine clinical practice.

Myth: SSRIs change your personality. 

SSRIs (or any antidepressants) are not capable of changing your personality. There is no drug currently on the market that has the capacity to do that (although it would be nice in some cases!). Some people do experience a small amount of emotional blunting on some SSRIs, but this can usually be addressed by switching to another drug in the same class. 

Myth: SSRIs make you aggressive or violent. 

This is the strangest one we’ve heard. Some have posited that SSRIs make people aggressive and violent. The evidence does not support a link between SSRIs and violence. In fact, people on SSRIs are more likely to be stable and show signs of reduced aggression. 

In short, SSRIs are not harmful. Spreading these kinds of myths just discourages people from taking medications that could significantly improve their lives and wellbeing. Unfortunately, we often read stories that sensationalize the bad experiences an individual has had with antidepressant medication, without telling the stories of the many people who have benefited from them or detailing the abundance of rigorously conducted clinical trials that led to their approval by the Food and Drug Administration (FDA).  Mental illness is already stigmatized – there’s no need to add more fodder to this already problematic phenomenon.