Bipolar Disorder, Alcohol Use, and Psychiatric Medications

Serious interactions are possible

Alcohol medication interactions can be dangerous
Alcohol/medication interactions can be dangerous. Peter Cade / The Image Bank / Getty Images

Alcohol Use and Psychiatric Drugs

"Do not drink alcohol while taking this medication" is in the instructions for many of the drugs prescribed for mental disorders (along with medications for many, many other conditions). Many people think it's because the combination "may cause drowsiness."

While that's quite true, there can be a lot more to the problem. Mixing some psych meds with alcohol can have far more dangerous results, anywhere in the range from alcohol abuse to just having an occasional drink.

Listed below are drug groups and drugs included in each group. In the table beneath are symptoms that may occur when people taking these drugs use alcohol.

Important Reminder: Some over-the-counter products, especially cough syrup and laxatives, may contain enough alcohol to interact with your medications. Ask at the pharmacy if a particular product is safe for you to take.

Medication Groups

These drugs, grouped by type, may have serious interactions with alcohol:

Group A: Anti-Anxiety and Sedating Drugs

The benzodiazepines, which include:

For a complete list of this type of medication, see Benzodiazepines Family of Drugs.

In addition, this group contains other drugs used for sleep, including:

Group B:

Tricyclic antidepressants, including:

  • Amitriptyline (Elavil)
  • Clomipramine (Anafranil)
  • Desipramine (Norpramin)

For a complete list of this type of drug, see Tricyclic Antidepressants.

Group C:

SSRI and SNRI antidepressants, including:

  • Celexa (citalopram)
  • Prozac (fluoxetine)
  • Lexapro (escitalopram)
  • Zoloft (sertraline)
  • Luvox (fluvoxamine)
  • Paxil (paroxetine)
  • Effexor (venlafaxine)

Group D:

Atypical antidepressants, which include:

  • Wellbutrin (generic bupropion)
  • Trazodone (brand name Desyrel)

This group also includes Serzone (nefazodone), which is only available in certain places outside the U.S., and the herb St. John's Wort, which has other potentially dangerous interactions.(see Warning).

NOTE: Interaction effects worsen if you are taking two or more medications in any of these groups.

Interactions and Medication Groups
Drowsiness, dizzinessAll groups
Increased risk of overdoseGroups A, B & C
Slow breathing or
Difficulty breathing
Groups A & D
Impaired motor controlGroups A & D
Unusual behaviorGroups A & D
Problems with memoryGroups A & D
Increased depression
Loss of effectiveness of antidepressant
Groups B & C
Hopelessness, increased risk of suicide or suicidal ideation in adolescents and young adultsGroups B & C
Convulsions, disturbance in heart rhythmGroup B

Sources:
Harmful Interactions: Mixing Alcohol with Medications. National Institute on Alcohol Abuse and Alcoholism. National Institutes of Health. Web. 22 January 2013.
Alcohol and Antidepressants PDR Health. Web. 28 January 2013.

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