The Alcohol and Antidepressant Use Conundrum

pouring_wineThere are two factors to consider when assessing the combined use of alcohol and antidepressants: first, the likelihood that an antidepressant’s effectiveness will be altered by alcohol (will consuming alcohol prevent or diminish the potential positive effects of the antidepressant?); and second, the chance that there will be some untoward and unintended consequences between alcohol and antidepressants.

Given the complexity of individual biochemistry, the answer to the first question is difficult to nail down; but it more than likely depends on the quantity and frequency of alcohol use. There are a few studies indicating that any amount of alcohol – even just one alcoholic beverage – can lead to a diminished antidepressant response. I recommend to those using antidepressants that they consume no more than two (2) alcoholic beverages a week. Of course, many balk at that recommendation.

As far as the untoward and/or unintended consequences of combining alcohol with antidepressants, it largely depends on the actions of the antidepressant prescribed, particularly its capacity for producing sedation. For instance, there is much less concern about additive sedation if alcohol is ingested in combination with a non-sedating antidepressant. On the other hand, combining alcohol with a sedating antidepressant may lead the individual to become more intoxicated than would otherwise be anticipated.

In the end, anyone taking an antidepressant that is reluctant to significantly modify or even relinquish their alcohol use, has a decision to make. To them, I pose this question: What’s the positive intention for possibly sabotaging your improvement by continuing to engage in a behavior that is not in your best interest? Often enough I get the response, “well, I want what I want when I want it.” I always remind those that cling to such a belief system that they do so at their own risk – a risk that may very well compromise their physical and emotional health.

Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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