Is It Possible to Overdose on Antidepressants?

How to Spot the Signs of Antidepressant Overdose

Yes, it is possible to overdose on prescription antidepressants. When someone overdoses on antidepressants, they may experience nausea, rapid heartbeat, headaches, and tremors; in some cases, they may experience seizures, respiratory distress, or fall into a coma.

When used properly antidepressants can be an effective means of treating depression, anxiety, and other mood disorders. However, they can have also serious side effects and be dangerous if taken incorrectly or used with alcohol or drugs.

Some people may misuse or overdose on antidepressants—intentionally or not—to increase the drugs' effects or because they are suicidal.

Overdoses are more commonly seen with older tricyclic antidepressants (TCAs), although newer selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) can also be misused.

If you suspect someone has overdosed on antidepressants or recognize symptoms of an overdose, call 911 or immediately seek emergency medical attention.

Keep reading to learn about the symptoms of antidepressant overdose so you know what to do if you are ever in this situation.

signs of an antidepressant overdose
Verywell / JR Bee

Signs of an Antidepressant Overdose

No matter if a person accidentally or intentionally overdoses, the symptoms are typically mild and non-specific in the first hour or two and progressively get worse.

The first signs of antidepressant overdose are usually symptoms that can all be attributed to other causes. These include:

Taking a single dose of someone else's antidepressants may cause one or several of the above side effects—but these will likely wear off in a few hours.

Still, it's advisable to contact a doctor and let them know if you take an antidepressant by mistake— especially if you have a mental health condition, are pregnant, or if you're taking any other medications that might interact with the drug.

For instance, if you're already taking another type of antidepressant such as a monoamine oxidase inhibitor (MAOI), you could be at risk for a drug reaction called serotonin syndrome if you consume a different antidepressant. The symptoms of serotonin syndrome include agitation, confusion, insomnia, rapid heartbeat, lack of muscle coordination, and muscle stiffness.

As the more serious effects of the overdose emerge, symptoms of may include:

  • Coma
  • Confusion
  • Delirium
  • Hallucinations
  • Increasingly rapid heart rate (dysrhythmia)
  • Involuntary eye movement
  • Respiratory distress
  • Seizures
  • Tremors
  • Unconsciousness

Seizures, cardiac dysrhythmia, respiratory distress, and coma are symptoms that can be life-threatening.

One of the earliest red flags of antidepressant overdose may be a rapid and irregular heartbeat (tachycardia), a condition not commonly seen in young people. This symptom warrants a call to 911 or an immediate visit to the emergency room.

If you have a prescription and take two antidepressants by accident, you may feel mild to moderate effects—especially if this is the first and only time you've accidentally doubled your dose. If you experience any side effects, contact a doctor immediately—even if the side effects feel mild.

You may want to talk to a doctor even if you don't experience any effects. They can offer reassurance and teach you to monitor yourself for possible side effects.

Treatment

Emergency medical interventions are often needed for serious antidepressant overdoses. Typically, efforts include pumping the person’s stomach and providing activated charcoal to absorb the remaining drugs if no contraindications are present. Both of these treatments should be done under medical supervision.

Intravenous sodium bicarbonate and other medications may also be prescribed to counteract the effects of the drug. The person will be kept hydrated with intravenous fluids.

If there are breathing difficulties, the person may need mechanical ventilation. The heart will be monitored and treatment will be provided for any cardiac problems. If the person experiences seizures, drugs will be given to control them.

Before being released from the medical facility they are being treated in, a psychiatrist will evaluate the person and determine whether further interventions are necessary to prevent another overdose. This may include:

Antidepressants and Suicide

Antidepressants are more likely to reduce suicide risk in the long run by improving mood, but in some cases, they may increase suicidal thoughts or behavior. This is more likely to occur in the first few weeks of taking an antidepressant or when the dose is changed, and is more common in children, teenagers, and young adults under 25.

The FDA requires that all antidepressants carry black box warnings, which are the strictest warnings for prescriptions. For instance, Lexapro has a black box warning that informs people of the risk of suicidal ideation or behavior as a result of taking the drug.

Some antidepressants are also linked to episodes of mania or hypomania in people with a history of these conditions. (Mania and hypomania are characteristic of bipolar I and bipolar II, respectively).

A study conducted in 2010 by the Centre for Suicide Research in Oxford, England aimed to identify which antidepressant drugs were more closely linked to suicide or attempted suicide. Researchers combed through coroners' reports and hospital admission records in six hospitals in the United Kingdom and Wales.

They found that TCAs had the overall highest toxicity and the highest rate of fatality compared to SSRIs and all other classes of antidepressants. This was especially true for the TCA drugs Prothiaden (dosulepin) and Silenor (doxepin). Of the SSRIs, Celexa (citalopram) had the highest toxicity and fatality rate.

It is important to remember terminating antidepressants abruptly can also increase the risk of suicide by 500% and the risk of attempted suicide by 700%.

You should never stop taking antidepressants suddenly; always talk with your doctor before making changes to your medication. Your doctor will advise you how best to discontinue your medication and whether you should stop your antidepressant gradually.

A Word From Verywell

Antidepressants can be a life-restoring therapy, but you should also be aware of their risks so you can recognize the signs of overdoses and prevent them.

If you or a loved one is taking an antidepressant, call your doctor or get emergency help if their depression seems to be getting worse or is causing suicidal thoughts that may lead to an overdose.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Nancy Schimelpfening
Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.