Is Mixing Alcohol and Antidepressants Dangerous?

Is It Dangerous to Mix Alcohol and Antidepressants?
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Question:  Is mixing alcohol and antidepressants dangerous?  What can I expect to happen if I don't follow my doctor's advice about abstaining from alcohol while I'm taking an antidepressant?

Answer:   Using alcohol while taking an antidepressant is generally discouraged by doctors for several very important reasons:

  • Many antidepressants can have sedating effects and they can increase the effects of alcohol, leading to greater drowsiness, impaired judgement and loss of coordination than a person would experience with alcohol alone.  If a person is not accustomed to how the combination of an antidepressant and alcohol affects him, he could be at greater risk for having an accident or injuring himself.
  • Alcohol use can potentially cause or worsen depression.  In addition, regular use of alcohol, even in small amounts, has been shown to reduce the potential benefits of antidepressants.
  • Combining alcohol with an antidepressant may put you at greater risk for liver injury.  A 2013 study indicates that, although rare, all antidepressants may potentially cause liver injury, especially in certain vulnerable populations, like the elderly, those with liver disease, those using certain illegal drugs and those taking multiple prescription medications.   Heavy alcohol consumption is also a factor which may increase the risk for liver damage with antidepressants.
  • Drinking alcohol could put you at greater risk for drug interactions if you are are already taking several different medications along with your antidepressant.   Your doctor may feel that adding alcohol to the mix could be a bad choice due to this increased risk.

    Certain types of antidepressants may also create unique risks to your health when alcohol is consumed:

    • Alcohol can potentially affect the metabolism of tricyclic antidepressants, leading to a greater risk of sedation, heart rhythm abnormalities and seizures.
    • When monoamine oxidase inhibitors are combined with tyramine-containing alcoholic beverages like beer and certain wines, it can lead to dangerously-high blood pressure.

      While it might seem like a good idea to temporarily stop taking your antidepressant if you plan to drink alcohol, this is not recommended.  Antidepressants need to be taken consistently for the best effects.  If you abruptly stop taking your antidepressant, you may become more depressed.  You may also have symptoms like fatigue, muscle aches, nausea or dizziness (discontinuation syndrome) if you don't take your medication regularly.

      Depending upon your own unique situation, it may be possible for you to drink moderate amounts of alcohol.  You should discuss this with your doctor to see what she recommends, based upon what antidepressant you are using, what other medications you are on and your general health.  She may also recommend that you exercise caution until you know just how alcohol in conjunction with your antidepressant affects you.

      Moderate drinking is usually defined as one drink per day for women and two drinks per day for men.  One drink would be the equivalent of 12 ounces of beer, 5 ounces of wine, 1 ounce of 80-proof whiskey or 1 ounce of 100-proof spirits.

      If your doctor has advised for you to not drink even small amounts of alcohol, but you are having great difficulty in giving it up, you may wish to use a screening tool like the Michigan Alcoholism Screening Test to determine if you might potentially have a problem with your alcohol use.  People with depression are at greater risk for developing a problem with their alcohol use than people without depression, perhaps because they tend to use alcohol as a way of self-medicating their depressed feelings.  About.com's Alcoholism Expert Buddy T also provides some very good resources if you'd like to learn more about alcohol and depression.

      Sources:

      Gharbia, Shereen A.  "Alcohol and Antidepressants:  The dos and don'ts of drinking when you take antidepressants are mostly don'ts."  PDRhealth.  PDR Network, LLC.  Accessed:  September 17, 2015.

      Hall-Flavin, Daniel K.  "Why Is It Bad to Mix Antidepressants and Alcohol?"  Mayo Clinic.  Mayo Foundation for Medical Education and Research.  Last reviewed:  June 12, 2014.  Accessed:  September 17, 2015.

      Pearsall, Katie and Steven M. Burghart.  "Ask the Pharmacist #20:  Effects of Wine Intake on Antidepressant Medication."  National Alliance on Mental Illness.  National Alliance on Mental Illness.  Accessed:  September 17, 2015.

      Selzer ML. "The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument." American Journal of Psychiatry. 127.12 (1971) : 1653-1658.

      Voican, Cosmin Sebastian, Emmanuelle Corruble, Sylvie Naveau and Gabriel Perlmuter.  "Antidepressant-Induced Liver Injury: A Review for Clinicians."  The American Journal of Psychiatry.  171.4 (April 2014):  404-415.

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