[Guest]

Dr.,

I am confused as to why the SSRI drugs and other anti-depressants can claim that they are not associated with addiction and dependency but benzo drugs are. My understanding is that addiction is marked by dependence, tolerance, withdrawal, and "drug-seeking behavior" where one willing risk negative consequences to obtain the drug.

1. Dependence: both anti-depressants and benzos can cause physical dependency (if defined as one needs the drug in order to function, even long-term), but this dependency is no different than one on heart or blood pressure medication.

2. Tolerance: Some people apparently seem to need to increase the level of benzos to achieve the same effect, they are marked as developing a tolerance. This certainly happens to some on Anti-depressant therapy, however, it is not labeled as tolerance but rather as a worsening of the illness requiring higher medication (what dictates the difference between tolerance and progression of an illness then?)

3. Withdrawal: Both types of drugs are clearly associated with withdrawal syndromes, though benzos seem to be more severe and dangerous "cold turkey"

4. "Drug seeking behavior": Only in cases of substance abusers do benzos appear to be associated with such a risk, and this group of people are not legitimate recipients of the drug in the first place (lacking of appropriate diagnosis for treatment). Otherwise, neither drug appears to be associated with this trait when used for therapeutice purposes.

Given the above, why are benzos labeled "addictive" and anti-depressants not? I'm not looking to bash anti-depressants, I just don't understand the distinction here. Thanks as always.

[Guest]

The addictive nature of the benzos is well understood. The medications make the anti anxiety effect of GABA more potent. The body diminishes the amount of GABA that is produced. Dosage may go up and withdrawal anxiety and even more severe symptms may ensue when the medication is stopped.

The SSRIs are less well understood. Dosage may or may not need to be increased. If the medication is continued to the point where the episode is over, there may be no need for continued treatment. The nature and cause of the discontinuation syndrome is unknown.

On the other hand some of the distictions are only semantic in nature.
[quote] Dr. ,

I am confused as to why the SSRI drugs and other anti-depressants can claim that they are not associated with addiction and dependency but benzo drugs are... [/quote]