Reports from 2015 to 2018 by the CDC show that 13.2 percent of American adults took antidepressants in the past month. A report by the National Center for Health Statistics shows that the number of Americans taking antidepressants has climbed by almost 65 percent since 1999.
Because the number of people using antidepressants is growing, it’s important to raise awareness of how the medication can interact with other substances, particularly alcohol. More importantly, studies show that people who are depressed tend to drink more than people who aren’t, which raises the risk for harmful drug interactions.
Here’s how antidepressants usually work, how alcohol can affect them, and the major risks of mixing the two.
How Antidepressants Work
In many cases, depression is attributed to having low levels of serotonin, a neurotransmitter, in the brain. Serotonin carries messages between different nerve cells in the brain and the rest of the body. It plays an important role in regulating mood, digestion, and sleep. Some antidepressants, like selective serotonin reuptake inhibitors work by increasing serotonin levels in the brain. They do this by preventing nerve cells from reabsorbing serotonin after carrying a message.
Similarly, classifications of medications like monoamine oxidase inhibitors can effectively reduce depressive symptoms. By balancing neurotransmitter levels in the brain, such medications allow improved mood, appetite, focus, quality of sleep, and energy levels. Some types of antidepressants can also alleviate nerve pain, migraine-related pain, and bodily pain to help users live happier lives
Alcohol and Antidepressants Interaction
Drinking alcohol can reduce the effectiveness of an antidepressant drug. Alcohol can also worsen feelings of depression and side effects of medication. That’s because alcohol is a depressant, which can intensify feelings of low mood. Binge drinking can be especially harmful, as the excess consumption of alcohol can impair people’s functioning, worsening symptoms of depression.
Here’s how alcohol interacts with different kinds of antidepressant medication:
SNRIs
These are serotonin and norepinephrine reuptake inhibitors that are commonly prescribed to reduce feelings of sadness and irritability. These aren’t compatible with alcohol, and mixing the two can increase the risk of liver damage.
SSRIs
These are the most common classification of antidepressant, and it’s generally safe to have alcohol while taking SSRIs. You can, however, experience more pronounced effects of intoxication.
TCAs
Tricyclic antidepressants work in a similar way as SSRIs in that they prevent the reuptake of norepinephrine and serotonin in presynaptic terminals. Having small amounts of alcohol while on TCAs is generally safe. However, binge drinking can worsen symptoms of depression, and mixing the two can increase effects of intoxication.
Atypical Antidepressants
Since some medications don’t entirely fit into other classifications, they’re categorized as atypical. Hence, medical consultation is required if you intend to drink while on atypical antidepressants. One example is that of bupropion, which increases the risk of a seizure when you mix it with alcohol. Other common atypical antidepressants include Agomelatine, Nefazodone, Trazodone, and Mirtazapine.
Regardless of the type of antidepressant your healthcare provider has prescribed, remember that most of them function irregularly when you mix them with alcohol. It’s true that some combinations only lead to minor side effects, but others can have a drastic effect on both your physical and mental wellbeing.
MAOIs
This classification of antidepressant works by inhibiting monoamine oxidase, which is involved in removing dopamine, serotonin, and norepinephrine from the brain. MAOIs are the most dangerous type of antidepressant to mix with alcohol. Some alcoholic beverages like wine and beer contain chemicals such as tyramines. When they react with MAOIs, they cause blood pressure to spike rapidly, which can be dangerous and requires urgent medical attention.
Major Risks of Mixing Alcohol with Antidepressants
Some of the major risks of taking antidepressants with alcohol are as follows:
Suicidal Thoughts
The interaction between alcohol and antidepressants can worsen depressive symptoms. Lower levels of inhibitors can mean a higher risk of suicidal thoughts and tendencies. In some cases, people suffering from alcohol use disorder that also take antidepressants may stop taking their medication so they can drink more.
Suddenly withdrawing from antidepressant medication can lead to a high risk of self-harm and suicide. In severe cases, withdrawal can even cause seizures.
Increased Anxiety and Depression
By taking both antidepressants and alcohol, your liver doesn’t get a chance to metabolize either. Because of this, depressive symptoms become more severe and more difficult to treat. While alcohol can help cope with depressive feelings by improving mood in the short term, it can mean facing debilitating anxiety and feelings of depression when the effect wears off.
Liver Damage
The liver is responsible for metabolizing and breaking down medication and alcohol. By taking both alcohol and antidepressants, your liver is working overtime, and it means neither is metabolized properly. To make matters worse, the liver doesn’t get a chance to regenerate. Over time, this can lead to liver damage, which can increase your risk of alcohol-related liver disease if you fail to practice proper drinking habits.
Excessive Drowsiness
As antidepressants can cause side effects like drowsiness, mixing it with alcohol can intensify the drug’s sedative effect. This slows down the central nervous system to a dangerous degree, leading to poor coordination. This means an increased risk of injuries and accidents while driving or operating machinery.
Developing a Substance Use Disorder
If you suffer from depressive episodes while taking antidepressants, you may start drinking as a way to cope. This increases your risk of developing an alcohol use disorder is you start consuming excessive amounts of alcohol. This can lead to an array of issues such as liver damage, miscarriage, and chronic alcoholism, which comes with its own issues like liver cirrhosis.
Skipping Doses to Have Alcohol
It may seem like a good idea to skip your dose of antidepressants if you want to have a drink, but this isn’t a good idea. Most classifications of antidepressants are only effective if you use them consistently. Although it doesn’t seem like a major problem to skip a single dose, it can cause depressive symptoms to return momentarily, increasing the risk of long-term relapse.
And skipping a single dose doesn’t mean that the medication still isn’t in your system. Thus, alcohol can still cause a reaction. Furthermore, sudden withdrawal from antidepressant medication can lead to a series of withdrawal symptoms, which become more severe due to alcohol.
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