SSRIs are not known to have very serious side effects but there have been recent reports of SSRIs inducing alcohol cravings. Research has found that antidepressants can intensify the effects of alcohol, or can lead individuals to increase their alcohol consumption and become heavily
In our practices, we have repeatedly noted that some people experience a marked change in alcohol tolerance during treatment with SSRIs and related drugs. The consequences include disinhibition of violence or sexual behaviour, sometimes with profoundly impaired memory of the event.
“If you've been on an antidepressant for a long time, your body may develop a tolerance,” notes Hullett. As a result, a medication that once worked well at quelling your sadness, anxiety, and other symptoms no longer has that power. Sometimes, Hullett says, increasing the dose under supervision by your doctor may help.
There are no antidepressants that are completely safe when taken with alcohol. Some providers may say that light to moderate drinking is OK while taking certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro).
Since alcohol can increase the body's production of dopamine and serotonin, two of the body's 'happy hormones', it can temporarily make us feel less anxious. Long term drinking, however, can lower levels of both these hormones as well as lowering blood sugar and increasing dehydration, leading to worse anxiety.
That aspect seems to stem from the fact that alcohol increases activity in the dopamine neurons in the mesolimbic reward pathway, as well as opioid cells that release endorphins. Both produce feelings of joy, pleasure, euphoria, depending on the type of activation. That's why drinking can be so pleasurable.
Individuals with ADHD may engage in impulsive behavior that can lead to harmful consequences. When they consume alcohol, these symptoms can increase. Alcohol can also intensify symptoms of inattentiveness and restlessness.
In general, it's not a good idea to skip doses of your antidepressant for any reason, including to drink alcohol. Most antidepressants are only effective when used consistently.
You should be wary of drinking alcohol if you're taking antidepressants, as alcohol is itself a depressant and drinking alcohol can make your symptoms worse.
Most antidepressants boost mood and reduce depression symptoms by elevating serotonin levels in the brain. Although this is beneficial for someone who's depressed, for someone who does not have depression, taking antidepressant medication can cause serotonin to build up in the body, resulting in serotonin syndrome.
On antidepressant medication, it is possible that you might experience a sense of feeling numb and less like yourself. Though the symptoms of depression have decreased, there may be a sense that other emotional responses – laughing or crying, for example – are more difficult to experience.
One of the widely-reported side effects of SSRIs is 'blunting', where patients report feeling emotionally dull and no longer finding things as pleasurable as they used to. Between 40-60% of patients taking SSRIs are believed to experience this side effect.
Some believe it is unlikely that antidepressants cause any permanent changes to brain chemistry in the long term. The evidence seems to indicate that these medications cause brain changes that only persist while the medication is being taken or in the weeks following withdrawal.
While the short-term effect of alcohol may boost serotonin, a chemical that increases feelings of happiness and wellbeing, the long-term repercussions of heavy alcohol use often include a decrease in serotonin production, leading to an increased chance of depression.
Acute Alcohol Effects on the Brain's Serotonin System
In humans, for example, the levels of serotonin metabolites in the urine and blood increase after a single drinking session, indicating increased serotonin release in the nervous system (LeMarquand et al.
It is also a good idea to drink slowly and eat some food while drinking to decrease the effects of the alcohol. However, you should not combine alcohol with your antidepressant until you know how your antidepressant will affect you. Many antidepressants will make people feel drowsy, dizzy, and less alert.
The anticonvulsants topiramate and gabapentin may reduce alcohol ingestion, although long-term studies are lacking. Antidepressants do not decrease alcohol use in patients without mood disorders, but sertraline and fluoxetine may help depressed patients decrease alcohol ingestion.
Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD–AUD.
Generally, drinking alcohol while taking antidepressants is not advised. Alcohol can make depression worse, and also increase the severity of antidepressant side effects. It's generally recommended that people on antidepressants abstain from alcohol, especially if they will be driving or operating heavy machinery.
Since antidepressants prevents reuptake of serotonin, it may lead to elevated levels of serotonin, which could cause manic symptoms, risky behaviour, and dangerous mood swings. Most research has been found to support SSRIs reducing alcohol consumption in animals and humans.
In general, mixing alcohol with antidepressants or any other drug is never recommended.
Several studies have shown a strong connection between ADHD, drug abuse, and alcoholism. ADHD is five to 10 times more common among adult alcoholics than it is in people without the condition. Among adults being treated for alcohol and substance abuse, the rate of ADHD is about 25%.
Increasing Impulsivity
Impulsivity is one of the symptoms of BPD, and for a person with BPD, alcohol can make an already impulsive individual even more impulsive. This means the individual is likely to go on spending sprees or participate in reckless driving, sexual promiscuity or binge eating.