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Comment by ddorian43 | Hacker News Reader

Which psychiatric drug is addictive ?

Amphetamines (used to treat ADHD and narcolepsy) and Benzodiazepines (used to treat anxiety disorders) are both well-known to be addictive. Benzodiazepines in particular can have fatal withdrawal symptoms if a patient quits them cold turkey.

SSRIs and SNRIs both have horrible withdrawal symptoms and can take months for patients to taper off if they decide to quit or change their meds.

SSRIs and SNRIs do not really meet the threshold for being considered addictive, however, since they do not induce any kind of euorphia, intoxication or immediate relief of depressive/anxious feelings.

Amphetamines and Benzodiazepines have a much higher potential for abuse, which is why prescriptions for them are carefully monitored by drug enforcement agencies.

My guess is that they're referring to the part where you can't just stop taking them cold turkey without a spectrum of bad things happening to you. It's a slow slow taper process.

That's not addicting. And kinda makes sense to tapper off (with many types of drugs).

No, I agree. I think "physical dependence" would be a much better word. People don't keep taking Zoloft because they want the next hit.

Funny you say this, because I moved, I've been out of my SNRI, and only took two in the last seven days. Last night I felt like a drug addict, I need to take it or I'll have withdrawals.

The sucky part is the withdrawals won't go away for several days at least....

If it's an instant-release, you can lower the dose little by little.

I mean more so that now that I'm back on my medicine, it's going to be a bit before I'm back at it's full effect.

Pretty much every SSRI (the most commonly used class of psychiatric drug? Not completely sure) has really nasty withdrawal after only a few weeks

But not addicting, your body/mind doesn't thirst for it.

That is false. Xanax withdrawal is extremely dangerous and suddenly stopping can cause death.

Please google Xanax addiction before posting more nonsense.

Addiction and dependency are two different things.

Addiction is the "thirst", the cravings for a drug/behavior. Addiction can be a form of psychosis. Addiction by itself never kills anyone but drives people to behaviors that can be fatal, such as ignoring the dangers of acquiring the drug.

Dependency is the adjustment of the patient's body to the drug, requiring both higher doses to attain the same result and a maladjusted state when the drug is not taken. Withdrawal is what happens when a person that is dependent on a drug does not get their drug, and in the case of Xanax, could be fatal.

Addiction can cause dependency, and dependency can cause addiction, but they are not the same.

Imo it is just semantics. I, personally, prefer to just separate those as "physical addiction/dependency" vs "psychological addiction/dependency". For example, xanax would qualify as physical, while cannabis as psychological.

P.S. Not trying to say that one can't use cannabis without being addicted, it is absolutely possible. But psychological dependence potential is there. Realistically, almost anything can be psychologically addicting imo

Xanax is not an SSRI but a benzodiazepine.

These are completly different drug classes.

Xanax isn't an SSRI.

Xanax is one. Many anti depressants can have severe withdrawal effects as well, though I suppose that is more indicative of dependency rather than addiction.

Yes, but xanax is only used short term I think.

Withdrawal isn't the same as addicting, no ?

Wrong again, Xanax is prescribed for years at a time. Many people go decades taking a few mg of Xanax a day.

In the US.

In eg the UK it's somewhat difficult to get xanax, but similar meds should only be used short term.

https://bnf.nice.org.uk/drug/alprazolam.html

> Avoid prolonged use (and abrupt withdrawal thereafter); debilitated patients (reduce dose) (in adults); elderly (reduce dose) (in adults); history of alcohol dependence or abuse; history of drug dependence or abuse; myasthenia gravis; personality disorder (within the fearful group—dependent, avoidant, obsessive-compulsive) may increase risk of dependence; respiratory disease

https://www.nice.org.uk/guidance/qs53/chapter/Quality-statem...

> NICE guidance provides recommendations on pharmacological therapies for anxiety disorders. Benzodiazepines are associated with tolerance and dependence, and antipsychotics are associated with a number of adverse effects. Therefore they should not be used routinely to treat anxiety disorders.

> Healthcare professionals should be aware of circumstances in which benzodiazepines and antipsychotics may be appropriate, such as short-term care and anxiety disorder crises.

Here's a website showing that alprazolam is not prescribed in the community:

https://openprescribing.net/analyse/#org=CCG&numIds=0401020A...

I've been on Xaxax 9 years, without it, I would be dead. I only take it infrequently though (10-15 days a month ?) so I can't comment on everyday usage and increasing tolerance. It does bother me quite a bit that my doctor only lets me be a functional human being approximately half the month, but, I'll take what little solace I can get. On higher regular (everyday) dosages seizure and even possibly death is a real possibility if you go into withdrawal, so I suppose I see where people are coming from. It doesn't make me feel any better the rest of the month though....

I suppose that's why I am so interested in these one and done kind of drugs, who wants to take a pill every day just to feel normal ? Nobody. I think the new study of these psychedelics (mdma therapy, psilocybin (especially), ketamine, dmt and their derivatives) really needs to be looked into so people can break the chains of the other medication they are on and live full happy lives.

You can change doctor and represent your case for a better outcome. And then change it again.

Is it the "feeling" that you take pills ? Everyone wants to take-pill-get-fixed with no side-effects for every disease.

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