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“I don’t want to give up Friday nights. I’m here. She’s concerned that medication will limit her usual glass (or two) of wine at her weekly dinner with her girlfriend. “I’m not good at alcohol, so it’s okay, right?”
Alcohol is one of the most common legal, non-prescription psychotropic drugs in the United States, with 54.9% of adults surveyed reporting having used alcohol in the past month, and 69.5% having used alcohol in the past. Reported drinking alcohol in the past year. Alcohol use can range from occasional drinking to heavy drinking (more than 3-4 drinks per day) to alcohol use disorder (AUD). Her 14.5 million Americans age 12 and older met her AUD criteria that year, according to the 2019 National Survey on Drug Use and Health.
Antidepressants are among the most commonly prescribed psychoactive drugs in the United States. Eleven percent of people over the age of 12 are taking antidepressants, making antidepressants the third most commonly used prescription drug among all adults. From age 18 he is the #1 prescription drug used among the 44-year-old age group.
Given the prevalence of both antidepressants and alcohol use, it is not surprising that the two often clash. To take or not to take while on antidepressants, that is the question. Here are some factors that help answer.
Effects of alcohol on mood
Although the direct effects of alcohol tend to be pleasure and relaxation, alcohol’s ultimate pharmacological action is to suppress neuronal activity in the brain. This may seem surprising given the association between alcohol and the early effects of disinhibition, ‘buzz’, and enjoyment. . So it can be difficult to get a full picture of how alcohol affects your mood.
The sedative effects of alcohol can increase sleep disturbances and worsen mood disorders. Furthermore, the presence of major depression doubles the risk of alcohol use disorders, and the National Epidemiological Survey of Alcohol and Related Disorders found that the presence of alcohol abuse increased the risk of major depression 3.7-fold.
Overall research suggests a bidirectional relationship between alcohol use and depression, with increased alcohol use correlating with increased risk of clinical depression and depression itself with increased risk of developing alcohol use disorders. increase the
Consequently, when assessing depression in patients, clinicians should also assess the use of comorbid substances that cause or contribute to the depressive episode. He 40-60% of people with AUD have substance-induced depression, and for some, their depressive episodes resolve when they stop using alcohol.
For others, alcohol abuse and depression are actually two separate diagnoses that exist at the same time (the so-called dual diagnosis), making each more complex and difficult to treat.
How does alcohol affect antidepressants?
Alcohol and some antidepressants compete for the same metabolic system in the body. Because of this competition, the body’s levels of both antidepressants and alcohol can be higher than either alone. These can range from sedation and dizziness to falls and even fatal overdoses.
Concomitant use with alcohol may also cause more extensive metabolism of some antidepressants, making them less clinically effective than usual.
Given this set of risk factors, psychiatrists may encourage patients to minimize or avoid alcohol use altogether. Less hurdles and more rest for your body in terms of dealing with side effects that are more frequent and intense than they need to be. It makes sense not only to minimize complications during the course of antidepressant treatment, but to try to recover from depression overall. increases.
Finally, when minimizing or completely abstaining from alcohol is difficult, the problem extends beyond occasional drinking to heavy drinking (3 or more drinks per day for women and 4 or more drinks per day for men). may reach. alcohol use disorder. In such cases, the effect of alcohol on depression may be even greater, justifying its own specific therapeutic focus.
Essential Reading for Alcoholics
Disclaimer: All content is for informational purposes only and is not intended as a substitute for direct medical advice from a physician or other qualified clinician. Should you require medical or psychological help , see your doctor or licensed mental health clinician for guidance, or call 911.
*Some names have been changed to protect patient privacy.