How to Tell If Someone Has Overdosed on Antidepressants

Antidepressants can be an effective means of treating depression, anxiety, and other mood disorders when used properly and taken in the prescribed doses. However, they can have 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 to commit suicide.

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. Learn the symptoms of antidepressant overdose so you can get assistance or help someone who has taken too much.

signs of an antidepressant overdose — Verywell / JR Bee

How to Tell If Someone Has Overdosed

Whether or not a person has accidentally or intentionally overdosed, the symptoms will typically be mild and non-specific in the first hour or two and progressively worsen over time.

The first signs of antidepressant overdose are usually symptoms that can all be attributed to other causes, including:

Nausea
Drowsiness
Dry mouth
Agitation
Headache
Vomiting
Diarrhea

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

As the more toxic effects emerge, symptoms may include:

Confusion
Delirium
Hallucinations
Tremors
Involuntary eye movement
Increasingly worsening heart pace (dysrhythmia)
Respiratory distress
Seizures
Unconsciousness
Coma

Seizures, cardiac dysrhythmia, respiratory distress, and coma are life-threatening complications.

Emergency Treatment for an Overdose

Emergency medical interventions for an overdose typically include efforts to pump the person’s stomach and provide activated charcoal to absorb the remaining drugs, if no contraindications are present. Both of these should be done within the first hour under medical supervision.

Intravenous sodium bicarbonate and other medications may also be prescribed to counteract the effects of the drug, and the person will also be kept hydrated with intravenous fluids. If there are breathing difficulties, the person may need mechanical ventilation. The heart will be monitored and treatment provided for any cardiac problems. If there are seizures, drugs will be given to control them.

Before being released, a psychiatrist will evaluate the person and determine whether further interventions, such as a change in medications, increased psychiatric care, and/or substance use interventions are necessary.

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, particularly in children, teenagers, and young adults under 25, and especially in the first few weeks after starting or when the dose is changed. The FDA requires that all antidepressants carry black box warnings, which are the strictest warnings for prescriptions.

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. To this end, the researchers combed through coroners' reports and hospital admission records in six hospitals in the United Kingdom and Wales from 2000 to 2006.

What they found was 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) was seen to have the highest toxicity and fatality rate.

On the flip side, terminating antidepressants abruptly can increase the risk of suicide by 500% and the risk of attempted suicide by 700%.

Never stop taking antidepressants suddenly; always talk with your doctor before making changes with 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 be aware of the risks so you can prevent overdoses and get treatment immediately if you recognize the signs. If you or a loved one is taking an antidepressant, call your doctor or get emergency help if the 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 1-800-273-8255 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.

Was this page helpful?

Thanks for your feedback!

What are your concerns?

Article 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.

Hawton K, Bergen H, Simkin S, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. Br J Psychiatry. 2010;196(5):354-8. doi:10.1192/bjp.bp.109.070219
Tackett B. Can You Overdose on Antidepressants? American Addiction Centers Resource. Updated November 1, 2019.
Liebelt EL. An update on antidepressant toxicity: An evolution of unique toxicities to master. Clin Ped Emer Med. 2008;9(1):24-34. doi:10.1016/j.cpem.2007.11.003
Woolf AD, Erdman AR, Nelson LS, et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(3):203-33. doi:10.1080/15563650701226192
Friedman RA. Antidepressants' black-box warning--10 years later. N Engl J Med. 2014;371(18):1666-8. doi:10.1056/NEJMp1408480