Author: John Carter

Consumer Health: It’s bad to mix antidepressants and alcohol

Alcohol can produce feelings of euphoria and excitement, making you feel instantly happier and more confident, but those feelings are fleeting. Much like barbiturates (sedatives), alcohol is a drug that affects the central nervous system (CNS) and the brain’s functionality. Alcohol and some antidepressants compete for the same metabolic systems in the body—that is, they both head for the exit doors at the same time once the body has ingested them. Because of this competition, the body’s levels of both the antidepressant and alcohol can be higher than with either alone. With a higher level of each in the system, potential side effects of both may be exacerbated.

“Therapeutic interventions designed to address both issues often include a focus on addressing emotional pain or trauma, as well as developing and practicing healthy coping behaviors,” says Kennedy. Concurrent use with alcohol can also cause some antidepressants to be metabolized more extensively and become less clinically effective than usual. Although the immediate effects of alcohol tend to be pleasurable and relaxing, the eventual pharmacological action of alcohol is to depress neural activity in the brain. This may seem surprising given the association between alcohol and its initial effects of disinhibition, “buzz,” and fun. The depressant effect is not readily apparent at first, which can make it difficult to see the full impact alcohol has on mood.

For many people, the first step in quitting alcohol abuse is to enter medical detox. Detox should not be considered as a replacement for comprehensive rehabilitation, but it remains an indispensable step during early recovery efforts. Medical detox entails a set of interventions designed to help you wean off alcohol gradually and safely to minimize the risk of harm and unpleasant or even dangerous side effects. If you’re at low risk of addiction to alcohol, it may be OK to have an occasional drink, depending on your particular situation, but talk with your health care provider. If you’re concerned about your alcohol use, you may benefit from substance abuse counseling and treatment programs that can help you overcome your misuse of alcohol.

1. Antidepressants work by altering levels of neurotransmitters in the brain to cause an enhanced effect on depressed mood and symptoms such as anxiety, insomnia (sleep problems), and suicidal thoughts.
2. Depression can also be directly caused by alcohol in the case of a substance-induced disorder.
3. People with depression are at increased risk of substance abuse and addiction.
4. We invite healthcare professionals including physicians, physician assistants, nurses, pharmacists, and psychologists to complete a post-test after reviewing this article to earn FREE continuing education (CME/CE) credit.
5. The resources below can help alert you and your patients to important potential risks.

Alcohol use can also affect how antidepressants work, which can affect depression treatment. Antidepressants are one of the most commonly prescribed psychoactive substances in the U.S. Eleven percent of people ages 12 and older take an antidepressant, and it is the third most commonly used prescription drug among all adults. Alcohol is one of the most common legal, non-prescribed psychoactive substances in the U.S., with 54.9 percent of adults surveyed reporting alcohol use within the past month and 69.5 percent reporting that they drank in the past year.

Examples of common medications known to interact negatively with alcohol

These can range from sedation and dizziness to falls and even fatal overdose. Given the prevalence of both antidepressants and alcohol use, it’s not surprising that the two often collide. More resources for a variety of healthcare professionals can be found in the Additional Links for Patient Care. Always check the warnings and interactions in the labeling for your antidepressant.

Depending on the severity of the disorders, you may need more intense treatment, such as outpatient care, integrated assertive community (ACT) treatment or a residential stay, which may be required to begin or continue your recovery journey. Kennedy suggests that treatment options can vary depending on the severity of your condition. Individuals diagnosed with clinical depression should be extremely cautious when it comes to using substances such as alcohol. According to Kennedy, for those taking antidepressants, combining them with alcohol can reduce their efficacy. No matter your drink of choice, alcohol can easily be abused and often is, especially when it’s used to self-medicate. Pouring yourself a glass of wine or cracking a beer at the end of a long day may temporarily relieve feelings of depression, because alcohol acts as a sedative, but it will exacerbate those feelings and actually intensify them.

In residential treatment, “an individual stays in a treatment setting, receives intensive therapy, and is physically separated from alcohol in order to recover,” says Kennedy. “Cells are living beings, and if you want to fix the issue of depression at the level of the cells, they cannot be inebriated,” says Taylor. “Alcohol makes us feel drunk and confused because alcohol makes the cells drunk and nonfunctional.”

You can always ask your pharmacist if you can take any medicine with alcohol. And never abruptly stop taking an antidepressant unless directed to do so by your doctor. You should avoid activities that requiring mental alertness such as driving or operating hazardous machinery until you know how the antidepressant affects you. The Centers for Disease Control and Prevention has found that 9 out of 10 adult binge drinkers don’t have a severe alcohol use disorder, but that doesn’t mean alcohol isn’t a problem for them.

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In many cases, one of the more tangible ways to support your mental health and reduce the likelihood of increased mental and physical health issues is to address the alcohol abuse problem and stop drinking all together. However, this should also be discussed in detail with your doctor or other treatment professional, as abruptly quitting drinking can result in a dangerous withdrawal syndrome in some individuals. In closing, combining alcohol with certain medications, particularly those with sedative effects, can increase the risk of adverse events, including falls, driving accidents, and fatal overdoses. The more alcohol a patient consumes, the greater the risk for alcohol and medication interactions.

Receive free access to exclusive content, a personalized homepage based on your interests, and a weekly newsletter with the topics of your choice. Receive free access to exclusive content, a personalized homepage based on your interests, and a weekly newsletter with topics of your choice. Naltrexone, Acamprosate, and disulfiram are also FDA-approved medications that can help curb alcohol cravings.

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Here, we describe briefly how alcohol and medications can interact, and we provide a few examples of common medications that could interact negatively with alcohol. We provide links to resources to help you mitigate these risks, including a consensus-developed list of potentially serious alcohol-medication interactions in older adults. It can be tempting to drink if you’re feeling unhappy, but there’s a better solution out there. When treating depression and substance abuse, consult with a mental health professional and/or an addiction specialist who can provide resources and recommendations for possible treatment options. Alcohol’s sedating properties can also increase disruptions to sleep, which in turn exacerbate mood disorders. Additionally, the presence of major depression doubles the risk of alcohol use disorders, while a National Epidemiologic Survey on Alcohol and Related Conditions found that the presence of alcohol abuse increases the risk of major depression by 3.7 times.

MAOIs are not frequently prescribed, but can be important treatments for patients who fail other treatments for depression. Many studies have found that alcohol dependence is closely linked to depression. When it comes to diagnosing an alcohol use disorder and a major depressive disorder, it’s important to address them simultaneously, as they can significantly impact your recovery. Drinking persistently and excessively can increase your risk of developing a major depressive disorder. It can also aggravate symptoms of pre-existing depression and endanger your health and mental health. In such cases, the impact of alcohol on depression becomes even more significant and may warrant its own specific treatment focus.

The resources below can help alert you and your patients to important potential risks. Given this array of risk factors, psychiatrists are likely to encourage their patients to minimize or completely abstain from alcohol use. It gives the brain less hurdles to clear in terms of alcohol’s depressant qualities, and it gives the body a break in terms of dealing with more frequent and intense side effects than needed. Not only does it makes sense for people to minimize complications during the course of antidepressant treatment but also while trying to recover from depression overall. Removing alcohol from the picture increases the opportunities for brain and body to function optimally. Monoamine oxidase inhibitors (MAOIs) are a class of antidepressants typically reserved to treat depression that is not responding to other medications, but they can cause serious interactions.

Whether you’re experiencing depression or not, it’s essential to evaluate your drinking habits and consider why you drink, when you drink, and how you feel when you drink. Depending on your intoxication level, you may experience decreased inhibition, loss of judgment, confusion, and mood swings, among others. John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).

Factors Contributing to Alcohol Use and Depression

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