Questions & Answers on Psychiatric Medications

Tadao Ogura, M.D.


Will I Become Dependent on Psychiatric Medications?

This question does not have a simple answer, either, because "dependency" has many dimensions and aspects.

"Dependency" may develop on mental, emotional, and/or physical levels. Furthermore, some people are genetically predisposed to become easily dependent on just about everything and anything while others may not develop any kind of dependency on anything whatsoever.

But let's try to understand what it means to be "dependent" on medication.

First, let us consider so-called "regular" medications. A diabetic who takes Insulin is "dependent" on it for maintaining normal physical (and "mental") functions. However, the diabetic person may still choose not to take it and stop it at any time as he or she is not mentally, emotionally, nor physically "dependent" on it. However, that person will surely become ill from such a choice, due to quickly elevating blood sugar levels.

This scenario applies to many other medications like heart medicines, hormones, and even anti-AIDS medications and also holds true for many psychiatric medications. This scenario may be called "Dependency by Needs."

Nevertheless, since psychiatric medications deal with "mental" and/or "emotional" conditions, they can bring about mental and/or emotional dependency as well. For example, if a person takes an antidepressant and feels "normal" and "great," that person may become "dependent" on it for fear of feeling depressed and terrible again without it. This case may be called "Dependency by Benefits."

On the other hand, if a person takes a drug like Cocaine or Heroin and enjoys getting "high" on it, that person may soon become "hooked" on it in order to maintain the high. That person is not seeking a "normal" state of his or her mind or body. Rather, that person is seeking more than a "normal" state. This type of dependency may be called "Dependency by Instant Gratification."

Another aspect of "dependency" is the "withdrawal" phenomena - which is what most people associate with "addiction." Too many people think that if you experience some "withdrawal" from a medication, you may have developed dependency on it. "Withdrawal" reactions do indicate a "physical dependency" in that your body cannot adapt quickly enough to the lowering or missing dosages of a medication and experiences various negative reactions during the withdrawal period.

All medications and drugs may potentially cause some form and degree of "physical dependency" once your body has gotten used to it. The severity of the "withdrawal" is, by and large, related to its "half-life." A half-life is the time your body needs to eliminate half of the initial blood level of a medication or a drug. In general, the shorter the half-life, the more severe the withdrawal reactions. Therefore, a drug with a very short half-life, such as Cocaine, tends to cause a very high level of dependency.

Psychiatric medications, like any other so-called "regular" medication, or illegal drugs, for that matter, can bring about any one of the above-mentioned phenomena. Therefore, one cannot make any blanket statement about the potential "dependency" that may be caused by all psychiatric medications. It depends on the medication and on the individual. As mentioned at the beginning of this section, some individuals develop very little or even no dependency of any kind while other patients seem to develop dependency on almost anything, based on their genetic dispositions.

All you have to do is to discuss this issue with your doctor for your particular case with the particular medication that is being prescribed for you. If you think you have a history of "dependency," mention it to your doctor as well.

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