If are taking a prescription antidepressant medication like Prozac (fluoxetine), you might worry that it could show up on a drug test. This is especially a concern if you must take a pre-employment drug screen for a new job.
Because antidepressants are not considered “drugs of abuse,” they are not included in common urine drug screens. However, there may be cross-reactions that can produce false positive results for the substances these tests are designed to detect.
Never stop taking your antidepressant without talking to your doctor first. If you are concerned about false positives on drug screenings, inform the technician about any medications you are taking, including antidepressants, other prescription medications, or over-the-counter medications.
Learn the actions you can take to ensure your drug test results are interpreted accurately and your rights are protected.
Common Drug Screens
Antidepressants do not show up as antidepressants on standard drug tests. The lab would have to do specific additional tests to look for antidepressants.
If you are in treatment for depression, the good news is that antidepressants are not the drugs that an employer is looking for in an employment drug screen. The types of substances tested for on a typical employment drug screens include:1
- Amphetamines, including methamphetamine
- Barbiturates
- Benzodiazepines (tranquilizers)
- Cannabinoids, including marijuana
- Cocaine
- Darvon (propoxyphene)
- Opiates, including heroin, oxycodone, and hydrocodone
- Phencyclidine (PCP)
Sometimes, however, an antidepressant will trigger a false positive on a drug test, showing up on the test as an amphetamine or lysergic acid diethylamide (LSD).
Impact of Antidepressants on Drug Tests
False positive test results can sometimes occur if a prescription drug or its metabolite has a similar chemical structure to the target drug being tested for.2
Some antidepressants can inadvertently trigger a false positive for a controlled substance.3 To avoid this, advise the tester about any medications you may be taking so that confirmatory tests can be performed to weed out any false positives.
Certain antidepressant drugs are more prone to false-positive readings. For example:
- Wellbutrin (bupropion),2 Prozac (fluoxetine), and Desyrel (trazodone)4 can all potentially show up as amphetamines on a drug screen.
- Zoloft (sertraline) may show up as a benzodiazepine. Less commonly, antidepressants have been known to trigger false positives for LSD.5
- Case reports also suggest that the serotonin-norepinephrine reuptake inhibitors (SNRIs) Effexor (venlafaxine) and Pristiq (desvenlafaxine) may lead to a false positive for phencyclidine (PCP).6
Preventing False Positives
If you are concerned that your antidepressant might show up as a false positive for another drug in a drug test, your best course of action is to be proactive.
Inform the Technician
In addition to informing the technician about the antidepressant your take, bring along the prescription bottle and ensure that the drug is notated on your record. It is better to declare this before the test rather than after.
Request a Second Test If Necessary
Due to the risk of false positives, all drug screen results should be considered presumptive until confirmed by a second testing technique, such as liquid or gas mass spectrometry.
If your drug screen is positive and a second confirmation test has not been done, demand that it be performed immediately, ideally with the same sample. Moreover, get a copy of both results to confirm that a different technique was used.
Talk to Your Doctor About Other Medications
If possible, you may want to talk to your doctor about trying a different type of selective serotonin reuptake inhibitor (SSRI) that won’t produce a false positive. For instance:
- Prozac (fluoxetine) or Zoloft (sertraline) may produce a false-positive result, whereas Paxil (paroxetine), Celexa (citalopram), and Lexapro (escitalopram) do not.7
- If you’re using an antidepressant to treat neuropathic pain, you may want to avoid taking Effexor XR (venlafaxine) and tricyclic antidepressants (TCAs), which are types of antidepressants that may be more likely to produce a false positive. Instead, you may ask your doctor about Cymbalta (duloxetine), which has a very low risk of producing a false positive on a drug test.
- If you are using an antidepressant as a sleep aid, avoid using Desyrel (trazodone) if possible. Remeron (mirtazapine) or sedative-hypnotics are alternatives that have less of a chance of producing a false positive on a drug test.
Of course, if a specific medication is working well for your depression—and you and your doctor agree it’s best not to change courses—be sure to show any and all medications to the lab technician conducting your drug screening.
Protecting Your Privacy
Even if you are able to sort out any false positives from your drug screen, you may be concerned about the disclosure of your antidepressant drug use.
In most cases, any information you share with the tester won’t be included on the result. The employees at the lab and your present or future supervisor will likely have no direct contact with each other. All your employer will receive is a list of positive and negative results to the requested drug screens.
Workplace harassment and discrimination for depression and other mental health conditions are prohibited under the Americans With Disabilities Act,8 but you may have valid concerns about your rights being upheld.
If you’re concerned about confidentiality, ask the tester for a copy of the company’s protected health information (PHI) documentation, outlining their legal duties and privacy practices as directed by the Health Insurance Portability and Accountability Act (HIPAA).
Although awareness about mental health conditions such as depression has grown over the years, it is still common for people with depression to worry about the stigma associated with a depression diagnosis.
It is understandable that you would want your depression diagnosis to be kept private, especially from a current or prospective employer. You may fear you could be discriminated against or singled out for your condition in the workplace, even with the legal protections in place.
Preparing for the Test
First and most importantly, don’t stop taking your medications or reducing the dosage unless you are doing so under the guidance of your physician. This is true even if you are concerned about false positives.
Even short-term interruptions in medication can have serious consequences for the treatment of your condition, not least of which is antidepressant discontinuation syndrome (ADS).9 Discuss any concerns you have with your mental health provider so you can take the drug screen safely and without stress.
It is also important to remember that antidepressants aren’t the only drugs that can trigger a false positive drug screen. Others include:10
- Advil (ibuprofen)
- Aleve (naproxen)
- Benadryl (diphenhydramine)
- Cardizem (diltiazem)
- Dextromethorphan (found in Robitussin)
- Glucophage (metformin)
- Ritalin (methylphenidate)
- Sudafed (pseudoephedrine)
- Trandate (labetalol)
- Ultram (tramadol)
References : https://www.verywellmind.com/can-antidepressants-show-up-on-a-drug-test-3972798