Antidepressants And Alcohol: Effects And Consequences Of Their Combination
The relationship between the simultaneous consumption of antidepressants with other psychotropic substances, such as alcohol, has been recently studied by different specialists. This is because the frequent use of alcohol is a common practice in people who have a diagnosis of depression, just as depression is a frequent phenomenon in people who have alcoholism.
In this article we will see what the mechanisms of action of both antidepressants and alcohol are, as well as some of the effects and consequences of combining both substances.
Antidepressant drugs and alcohol: mechanisms of action
The prescription of antidepressant drugs is based on considering that depression is characterized by a decrease in serotonin levels (neurotransmitter associated with the activation of pleasant emotions).
Thus, antidepressants have the main objective of compensating for this decrease by ensure that serotonin is concentrated for longer in the synaptic space This compensation can in turn favor the concentration of other substances and, depending on what they are, the adverse effects of antidepressants can increase or decrease.
The main types of antidepressants are the following:
How does alcohol work?
On the other hand, alcohol is a chemical substance that has different uses and is present in various organisms and natural compounds. Ethyl alcohol, also known as ethanol is the psychoactive substance found in recreational alcoholic beverages, such as wine, liquor or beer.
Its main effect is depression of the central nervous system, since it produces neurochemical inhibition in GABAa receptors. In high consumption, and as a depressant, ethanol has consequences such as behavioral disinhibition combined with states of euphoria, drowsiness, dizziness low reflexes, slowing down movements, decreased vision, among others.
Its effects are very similar to those produced by psychotropic medications such as benzodiazepines and barbiturates, since they act on the same neuronal receptors.
Having said the above, we can describe some of the main effects that it can cause. combining antidepressant drugs with alcohol consumption
Effects and consequences of their combination
As we have seen, alcohol consumption in depression is common, however, its interaction with antidepressants in people who have the diagnosis has been little studied, except in those who have problematic consumption of alcoholic beverages.
In these studies it has been seen that the combination of antidepressants and alcohol generates a potentiation of the effects that alcohol produces on its own. For this reason, Mixing alcohol with other antidepressants is contraindicated Below we will list some of the main reasons in more detail.
1. Enhance the sedative action
The clearest and best known effect of combining antidepressants with alcohol is the high probability of increasing their depressant or sedative effects on the central nervous system. The latter occurs both in the case of SSRIs (for example duloxetine, floxamine, fluoxetine or citalopram), as in the case of tricyclic and tetracyclic antidepressants (such as imipramine or mirtazapine).
The consequence of the above is an increase in the experience of depression symptoms in the medium term, as well as a prolonged decrease in alertness, coordination, motor skills, and a significant increase in drowsiness.
Likewise, the combination of alcohol and SSRI antidepressants, such as venlafaxine, and related medications, has been associated with a change in alcohol tolerance and with the exacerbation of the behavioral effects that the latter produces, such as disinhibition of violent and sexual behaviors along with impaired memory.
2. Interfere with alcohol metabolism
Especially when it comes to MAOI antidepressants, alcohol is contraindicated, because these drugs inhibit the oxidative activity of liver microsomal enzymes, which interferes with the metabolization of chemical compounds such as ethanol; but also with the metabolism of caffeine, analgesics, barbiturates and other antidepressants.
At the same time, This enhances the psychotropic effects of the substance with which it is mixed (both ethanol and the aforementioned drugs). Because MAOIs interact with different substances easily found in foods and drinks, it is important to take precautions with what you consume. Improper mixing can cause increased blood pressure and severe adverse reactions.
3. Increases the risk of adverse drug effects
As with many other medications, mixing antidepressants with alcohol increases the likelihood of adverse effects associated with the medication. For example, significant anxiety states, sleep disorders, and damage to different organs
4. Sleep disturbances
Because alcohol causes drowsiness, and sometimes depression is characterized by difficulty falling asleep, drinking alcoholic beverages becomes a common resource. However, this is a short-term effect, since although alcohol consumption can cause rapid sleep, It is also common to alter circadian rhythms and causes states of wakefulness at midnight.
Use of antidepressants in the treatment of alcoholism
As we have said, alcoholism and depression are phenomena that frequently accompany each other. In addition to this, Different symptoms caused by alcoholism have been treated through pharmacological prescriptions diverse.
Although the use of anxiolytics is more frequent, since anxiety is considered one of the main causes of alcoholism, the use of antidepressants in phases of cessation in alcoholism treatments has recently been studied. This phase is the one that consists of eradicating psychological dependence on alcohol.
For example, trazodone, which is a serotonin antagonist and reuptake inhibitor. used for the treatment of chronic alcoholism Likewise, venlafaxine (sometimes combined with fluoxetine), which are selective serotonin reuptake inhibitors, is used to treat different types of alcoholism.
