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  1. #1
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    Post Medications and Alcohol: How much is bad for you?

    Alcohol: How much is bad for you?
    by Chris Ballas, M.D.
    Tuesday, March 6, 2007

    I am often asked if a glass of wine is ok if you are on medications. My standard answer--you shouldn't do it--isn't rigorous, and a better answer might be that alcohol's effects are magnified.

    Part of the problem is that a "drink" isn't the same to everyone. Different countries have different "standard drinks" ranging, usually, from 10g to 14g per drink. As a reference point, there are about 14g in a 12 oz beer (5% alcohol by volume) and 77g in a bottle of wine (13% alcohol by volume.) So there are about six "drinks" in a bottle of wine.

    Let's leave aside the impact of alcohol on psychiatric illness, and focus only on its effects on medications.

    Surprisingly little formal study has been done on the interaction between alcohol and SSRIs. One study found that Prozac's inhibitory effect on liver enzymes doesn't necessarily translate to an increase in alcohol or its effects. Another study found that SSRIs did not diminish the intoxicating effects of alcohol (in mice), but did reduce the relaxing effects of alcohol. However, a handful of studies found that SSRIs don't magnify the cognitive effects of alcohol.

    Another way of looking at this is to ask if it is recommended for psychiatrists to alter the doses of SSRIs in alcoholic patients. The answer: No. Generally, we dose SSRIs the same in current drinkers as in anyone else (though of course we caution our patients not to drink.) There is also enough evidence showing that treatment of depression reduces alcohol consumption (in people trying to get clean.)

    I don't mean to imply that it is now okay to drink while on an SSRI; I mean that drinking is not a reason not to start one, if it is indicated. Check with your doctor.

    I should point out that organ damage due to alcohol is a reason to change the dose of SSRIs. For example, someone with cirrhosis should probably get a lower starting dose, and then of only certain SSRIs with less liver metabolism.

    Finally, other depression medications--for example benzodiazepines--are definitely risky with alcohol. In all of these situations, it is best to be completely upfront with your doctor and so the safest and most effective treatment plan can be initiated.

  2. #2
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    Re: Medications and Alcohol: How much is bad for you?

    Interesting, it should also be noted that tricyclic antidepressants should NEVER be used with alcohol because it decreases your tolerance to alcohol immensely, and you could end up with alcohol poisoning from a normal portion that you were having when not on this particular med. And no this is by no means a way to make you a 'cheap drunk', you will go from slightly buzzed to dizziness and vomiting in a blink of an eye, it's no fun.
    "Remember in the depth and even the agony of despondency, that very shortly you are to feel well again"-Abraham Lincoln

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    Re: Medications and Alcohol: How much is bad for you?

    I was told not to drink any alcohol on Lithium...not even one beer. I'll just drink a non alcoholic beer, not the same but oh well.

  4. #4
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    Re: Medications and Alcohol: How much is bad for you?

    I know I was told it's a no no taking alcohol while on medication. But I have been doing it again this weekend. Last night I had 2 beer then took one of my bedtime meds and right I am about to have a beer even though I took my medication earlier to calm me down and hopefully would let me fall asleep but I didn't fall asleep. So I just ate something and now I am taking my beer.

    I two appointments on Thursday. One with my Psychiatrist out of town and my local Psychoanalyst late in the afternoon.

    Sue

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    Re: Medications and Alcohol: How much is bad for you?

    Are you drinking just because you want to? Couldnt' you have water or ice tea instead? Do your doctors know you're mixing alcohol with drugs? Are you watching for and aware of side effects?

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    Re: Medications and Alcohol: How much is bad for you?

    hopefully would let me fall asleep
    During the day? Sleeping during the day (other than a short nap) can make any existing insomnia worse.

    If taken at night, alcohol disrupts the quality of sleep.

    Personally, some of the ways I relax are by exercising, listening to relaxing music, stretching, watching TV, or taking a hot shower.

  7. #7
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    Re: Medications and Alcohol: How much is bad for you?

    I am drinking and trying to fall asleep because I want to become numb and not feel anything. I want to escape reality for a while. Then hopefully when I wake up I will feel better. I don't enjoy the taste of alcohol.

    My DRs know in the past I have done it and told me it dangerous.
    I emailed one and called the other and told them about last night.

    But I am in the same mood as last night don't care. I am overwhelm with life right now. Also trying to get a new job to work for the government and other stuff going on in my life.

    Sue

    PS: Thanks Everyone

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    Re: Medications and Alcohol: How much is bad for you?

    I want to escape reality for a while.
    There's the phrase "escape into a movie" , aka cinematherapy, or "escape into a book," aka bibliotherapy.

    To paraphrase Marsha Linehan, most people, when they feel they are in a crisis, usually only make things worse, such as by self-medicating with alcohol.

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    Re: Medications and Alcohol: How much is bad for you?

    Thanks Daniel
    Maybe I should have said escape life in general for a while. I have been watching a bit of TV today but it's still reality. By sleeping maybe i can have good dreams of a better life.
    So I am trying to escape and ready fiction book isn't going to help but that remind me of work books I bought recently to improve my french I should go find them.

    Sue

  10. #10
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    Re: Medications and Alcohol: How much is bad for you?

    Quote Originally Posted by suewatters1 View Post
    I have been watching a bit of TV today but it's still reality.
    What channels are you getting? The closest thing to reality I see on TV these days is The Simpsons.

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