So a little bit of background information on the medication I am discussing in particular. I think that the potential clash between medicine and alcohol will vary amongst different meds so I just want to make it perfectly clear which one I am talking about! The anti-depressant that I have personally been taking (and was taking in 2014) is fluoxetine. This is also largely known as Prozac. Fluoxetine is a long-term medication which you take to control your symptoms and as such it is really important to understand them inside and out – particularly when it comes to their potential clash with other meds. Fluoxetine is a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These drugs work with neurotransmitters in the brain to help those with depression and anxiety and for most people, they come with very limited side effects.
When I took my first ever course of anti-depressants I was completely ignorant of the pamphlet that accompanied them. I think at that point I was just incredibly dubious of the strength and impact that they might have, and so naively I didn’t even stop to consider that they might clash with other medication or drugs (namely alcohol). Stupid? Yes. But let’s be honest, my mind was pretty preoccupied at this point.
My first experience of fluoxetine combined with alcohol was enough to scare me into being completely tee-total whilst taking them for a long while after. Soon after diagnosis I had an appropriately timed family holiday to Spain. I was too ashamed at this point to be honest with my parents about being depressed, so they weren’t any wiser to inform me that drinking was probably a bad idea. Cue the first night out for dinner (involving wine) and I had what was probably the scariest night of my life; psychologically speaking. I was a complete MESS. Not just emotional, but slightly deranged – the clash between fluoxetine and alcohol had made me shower fully clothed when we got back to the villa, amongst other VERY odd behaviour. It essentially made me make a massive fool of myself in front of the whole family. Of course, they were understanding (if not slightly confused, and worried that me and my brother had perhaps taken a drug of other sorts) and at least it prompted a conversation about the reasons behind the meds I was taking.
Three years on, and I am taking Fluoxetine again. It is safe to say that I am very guarded about my alcohol intake now. I haven’t (surprisingly) gone tee-total again. I’ve tested the waters – though not too deeply – and so far things have been going ok. Having said that, I wouldn’t want to push the boundaries to more than a few glasses of wine. With the festive period upon us, and the Work Christmas Do later this evening (yikes) I wanted to research what the effects of drinking alcohol on anti-depressants really are, and whether I should be avoiding it altogether.
So, the advice from my GP was vague. Apparently I am allowed to drink… but not too much. But how much IS too much?! This differs from person to person.
The NHS website lacked clarity too. It advises that you can drink whilst taking antidepressants, but that there are side effects that can arise if you choose to do so. Does that provide an answer? Nope. I think not.
Not only is alcohol a depressant anyway, but it can also reduce the effectiveness of your antidepressants, making you feel more depressed and making the depression harder to treat.
This is a very important point to bear in mind.
As mentioned above, Fluoxetine/Prozac are SSRIs, which work by increasing the level of serotonin in the brain.
Alcohol is a depressant. It decreases the level of serotonin in our brains.
What this means is that when you drink while taking antidepressants, the effects of your medication can be significantly lessened – to the point that you may experience extreme lows or suicidal thoughts.
Some of the effects of drinking whilst taking Fluoxetine:
- Sudden fatigue/weakness
- Make you prone to alcohol abuse as those with depression are known to be at a higher risk of drug abuse and dependence
- Increase antidepressant side effects – nausea, etc
- Feelings of hopelessness
- Increase in suicidal thoughts
It depends on how you’re FEELING (yep, more vagueness, sorry)
Andrew Solomon, a professor of clinical psychology and among the world’s best-known depressives, described the effects of alcohol on antidepressants as follows…. “It definitely varies by how I’m feeling overall. When I’m in good spirits — no pun intended — I am easier about this; when I feel more fragile, I’m more cautious.”
I think it is safe to say, that overall, many people would be much safer to avoid alcohol altogether. People with depression are far more likely to develop a dependency on alcohol, so perhaps the increased abstinence through negative side effects should be appreciated. Also interestingly, it has been proven that we actually become more sensitive to the effects of the clash between the two drugs as we age – particularly those mid-life, when body chemistry is changing.
I titled this blog “The Truth About Drinking on Antidepressants”. “Truth” is perhaps a bit of a strong word. The truth is, everyone will have a different reaction, and it is up to us on our own to test our boundaries carefully and in very small doses of booze. When I say small, I literally mean half a glass of wine and/or half a pint. If you don’t usually feel the urge to drink normally anyway, then you are certainly better off avoiding it altogether if you don’t want to risk a Jess-Spain-episode.
The reality is that most of us are partial to a tipple (shout out to the people who use booze to help with their social anxiety too!) and if your antidepressants are making you less likely to socialise as a result then they’re not doing their job very effectively in my opinion. Find YOUR boundary, with care, and make sure that whatever you do you don’t push past that boundary.