Antidepressants and Alcohol

Antidepressants are drugs which interact with the dopamine and serotonin neurotransmitters in the brain. These chemicals are known to be responsible for mood balance and general well-being.

Alcohol itself will suppress the central nervous system. When consumed with antidepressants, different reactions can occur. Reactions are based on amount of the drug, alcohol, and individual factors such as tolerance. In any case, the results can be detrimental to mental health.

Antidepressants and alcohol may consist of two different reactions: one, there is interference with medication in the liver. Two, the effects of the medication are enhanced by alcohol, particularly in the central nervous system. This is when the sedating effects of each drug begin to build upon each other.

Antidepressants and Alcohol Reactions

Tricyclic Antidepressants

Tricyclic antidepressants (TCA) are very sedating. When alcohol is consumed, these effects are enhanced by increasing the levels of the drug in the body. High TCA levels may be responsible for an irregular heart rhythm and convulsions. Drugs in this class include:

  • mitriptyline
  • Amoxapine
  • Desipramine (Norpramin)
  • Doxepin
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)
  • Trimipramine (Surmontil)

Selective Serotonin Uptake inhibitors (SSRIs)

SSRIs are less sedating that TCAs, and are generally the safer choice when mixed with alcohol. Although effects are usually minor with moderate alcohol consumption, any interaction can increase sedation, soften motor skills, and impairing driving ability. Drugs in this class include:

  • sertraline (Zoloft)
  • fluoxetine (Prozac)
  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • paroxetine (Paxil, Pexeva)
  • fluvoxamine (Luvox)
  • trazodone (Oleptro)

Monoamine Oxidase Inhibitors (MAO)

MAO inhibitors have risky side affects when taken in combination with some alcoholic beverages, Beer and red wine especially, as they contain tyramine, an agent which can interact with the drug to induce extremely high blood pressure. Drugs in this class include:

  • socarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Emsam), a transdermal patch
  • tranylcypromine (Parnate)

Antidepressants and alcohol use is not a good means of controlling depression. Alcohol by itself can increase depression, while simultaneously reducing the effectiveness of the drug.

In a nutshell, taking antidepressants and alcohol enhance the effects of either drug, so the person becomes more and more drowsy and drunk than they would if confined with the effects of just one substance.

Note: Minimal to moderate alcohol consumption may not yield noticeable effects – most studies concentrate on heavy drinking cases.

Other Dangers and Possible Interactions

The Comedown Effect: People recovering from hangovers or alcohol withdrawal syndrome will feel all the usual comedown effects of intoxication, which may include depression, anxiety, irritability, and lethargy.

Fatality: In extreme cases, death may occur for persons using antidepressants and alcohol. This is more likely when combined with other drugs, such as painkillers or other system depressants.

DUIs: And due to the antidepressants effect on the alcohol, anyone who is on an antidepressant while drinking and driving has the added danger of impaired motor skills.

Too much of a Good Thing: Heavy alcohol consumption and antidepressants both work to increase serotonin. Too much serotonin in the brain can cause something called Serotonin Syndrome. Symptoms include

  • Agitation or restlessness
  • Confusion
  • Rapid or irregular heart rate and high blood pressure
  • Loss of muscle coordination or twitching muscles
  • Sweating and  shivering
  • Diarrhea
  • Headache
  • High fever
  • Seizures
  • Unconsciousness