Alcohol consumption and the use of antidepressants PMC


However, significant gaps remain in our understanding of these two disorders, and these gaps present important opportunities for future research. Some researchers have suggested that the effects of psychotherapy may account for some of the pill placebo response observed in medication studies. For example, a person with frequent episodes of severe depression may turn to drinking to self-medicate. People who frequently drink are more likely to experience episodes of depression, and they may drink more in an attempt to feel better. Children who have major depression as a child may drink earlier in life, according to one study. Major depression and alcohol use disorder are also co-dependent in women, research suggests.

  1. Individuals with mental health conditions may be more likely to use alcohol as a treatment.
  2. Combining alcohol with antidepressants can not only lead to short-term complications, such as an increase in the side effects of the antidepressant, but can also contribute to long-term consequences.
  3. Depression and anxiety can sometimes get worse during pregnancy and after your baby is born.
  4. The more alcohol a patient consumes, the greater the risk for alcohol and medication interactions.

Some doctors think it’s OK to drink moderately if you take an SSRI like Lexapro. “Moderate drinking” means 2 drinks a day for men and 1 drink a day for women. One drink equals 12 ounces of beer, 5 ounces crack cocaine symptoms and warning signs of wine, or 1 ounce of hard liquor. You should avoid activities that requiring mental alertness such as driving or operating hazardous machinery until you know how the antidepressant affects you.

Factors Contributing to Alcohol Use and Depression

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. 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. Joining a support group or a 12-step program such as Alcoholics Anonymous may help.

TCAs work by increasing levels of norepinephrine and serotonin in the brain while blocking acetylcholine. Scientists believe this interaction helps to restore proper balance in the brain and can help to alleviate symptoms of depression. SSRIs are the most commonly prescribed antidepressant, as they are highly effective at treating depression and typically cause fewer adverse side effects than some of the other types of antidepressants. SSRIs work by blocking the absorption of serotonin in the benzo withdrawal timeline and symptoms brain, which allows messages to be more freely sent and received throughout the brain. The substantial variability in the course of co-occurring AUD and depressive disorders may reflect discrete underlying mechanisms, requiring distinct treatment approaches. For example, AUD that develops after the onset of a depressive disorder and is characterized by coping motives for alcohol use may differ critically from a depressive disorder that develops following chronic alcohol administration.

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“In our society alcohol is readily available and socially acceptable,” says Jill Bolte Taylor, PhD, author of Whole Brain Living, explains. “Depression and alcohol misuse are often tied because we take a depressant to counter a chemical depression which only makes it worse.” John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine.

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. 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. 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. Depending on your intoxication level, you may experience decreased inhibition, loss of judgment, confusion, and mood swings, among others. The bottom line is that there are many reasons not to combine alcohol with antidepressants.

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But usually, doing it can just make it harder to do tasks that require you to be sharp and alert. Drinking alcohol can also lead to more and different side effects — and risks — when combined with the drug. If you take the SSRI antidepressant Lexapro for depression or anxiety, you may wonder if it’s OK to have a cocktail, beer, or glass of wine once in a while. But there are lots of reasons to stay away from alcohol when you take antidepressants like Lexapro, which is the brand name of a drug called escitalopram.

Understanding the Mechanism of Action of Antidepressants

However, the flip side is that people who frequently use alcohol are more likely to also be depressed. Drinking a lot may worsen these feelings, which may actually drive further drinking. The “burst” of energy from alcohol can be a welcome relief against some symptoms. MAOIs are typically a second-line prescription for depression when other classes of antidepressants aren’t working, as they interact with other medications and food, causing adverse side effects. Because alcohol can cause depression on its own and make some antidepressants not work well, this could lead you to think about suicide. In extreme cases, drinking alcohol while taking an SSRI like Lexapro can sometimes lead to side effects such as becoming violent.

If you’re dealing with severe alcohol withdrawal symptoms, such as anxiety, insomnia, nausea, and hallucinations, among others, then your doctor may suggest medications such as chlordiazepoxide or other benzodiazepines. At the same time, people with depression may attempt to self-medicate with alcohol. Some of those studies did not identify the substance included in their studies, making the outcomes to all types of abused substances unsupportive in that area. Additionally, only SSRI was examined in combination with medications for alcohol dependence. Consequently, this drives the requirement for future studies that examine other anti-depressants with a different mechanism of action in this clinical setting.

It’s important that your doctor can assess your case before you start drinking while taking a prescription. It may also be important to periodically check your overall health if you’re taking prescription medication long-term, especially if you drink alcohol. In particular, you may need to check your liver and kidney health every so often. The same is true for many prescriptions, even rounds of certain antibiotics. MAOIs are no longer the first line of antidepressant use because they are known to interact poorly with certain foods and medications, including alcohol, in ways that can produce dangerously high blood pressure.

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). Concurrent use with alcohol can also cause some antidepressants to be metabolized more extensively and become less clinically effective than usual. If a decision is taken to switch you from a particular type to another, the dosage of the first antidepressant will usually be gradually reduced before the second is started.


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