Antidepressants and alcohol: effects and consequences of their combination

The combination of these two psychoactive substances can have very serious effects on the body.

The relationship between the simultaneous consumption of antidepressants and other psychotropic substances, such as alcohol, has recently been studied by various specialists.has recently been studied by different specialists. This is because the frequent use of alcohol is a common practice in people diagnosed with depression, just as depression is a frequent phenomenon in people with alcoholism.

In this article we will see what are the mechanisms of action of both antidepressants and alcohol, 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 the consideration that depression is characterized by a decrease in serotonin levels (a neurotransmitter associated with the activation of pleasant emotions).

Thus, antidepressants have the primary objective of compensating for this decrease by ensuring that serotonin is concentrated for longer in the synaptic space.. This compensation may in turn favor the concentration of other substances and, depending on what they are, the adverse effects of antidepressants may increase or decrease.

The main types of antidepressants are the following:

• MonoAmino Oxidase enzyme inhibitors (MAOIs), which may have an irreversible or reversible effect, and whose use is recommended only in cases where there is no response to other treatment, due to their high health risk.
• Tricyclic and tetracyclic antidepressants, which prevent the reuptake of serotonin, but also of noradrenaline, as well as other substances such as acetylcholine.
• Selective Serotonin Reuptake Inhibitors (SSRIs). This is currently the most widely used antidepressant because its adverse effects are less than those of the other psychotropic drugs.
• Selective Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs), which, like tricyclics, prevent the reuptake of both serotonin and noradrenaline, prevent the reuptake of both neurotransmittersHowever, they have less risk of adverse effects.
• Serotonin reuptake antagonists and inhibitors (SRIs), which also have hypnotic effects.
• Selective Catecholamine Reuptake Inhibitors (adrenaline, noradrenaline, dopamine).

How does alcohol work?

On the other hand, alcohol is a chemical substance that has different uses and is present in several organisms and natural compounds. Ethyl alcohol, also known as ethanolis the psychoactive substance found in alcoholic beverages for recreational use, such as wine, liquor or beer.

Its main effect is the depression of the central nervous system, since it produces a neurochemical inhibition of GABAa receptors. At high consumption, and as a depressant, ethanol has consequences such as behavioral disinhibition combined with states of euphoria, somnolence, dizziness, reduced reflexes, slowed reflexes, slowed reflexes, and a loss of alertness.The effects of ethanol are very similar to those of other drugs, such as: decreased reflexes, slowing down of movements, decreased vision, among others.

Its effects are very similar to those produced by psychotropic drugs such as benzodiazepines and barbiturates, since they act on the same neuronal receptors.

Having said this, we can describe some of the main effects that can be caused by the combination of 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 with the diagnosis has been little studied, except in those who have a 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 alone produces. For this reason, mixing alcohol with different antidepressants is contraindicated.. Some of the main reasons for this are listed below in more detail.

1. Enhancing 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 and in the case of alcohol. (e.g. duloxetine, floxamine, fluoxetine or citalopram), as in the case of tricyclic and tetracyclic antidepressants (e.g. imipramine or mirtazapine).

The consequence of the above is an increase in the experience of depressive 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 toleranceand with exacerbation of the behavioral effects of alcohol, such as disinhibition of violent and sexual behaviors along with impaired memory.

2. Interfering with alcohol metabolism

Especially when it comes to MAOI antidepressants, alcohol is contraindicated, because these drugs inhibit the oxidative activity of hepatic microsomal enzymes, which interfere with the metabolism of chemical compounds such as ethanol; but also with the metabolism of caffeine, analgesics, barbiturates and other antidepressants.

In turn, this enhances the psychotropic effects of the substance with which it is mixed. of the substance with which it is mixed (both ethanol and the aforementioned drugs). Because MAOIs interact with different substances that are easily found in food and beverages, it is important to take precautions with what is consumed. Improper mixing can lead to 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 disturbances, and organ damage..

4. Sleep disturbances

Because alcohol causes drowsiness, and depression is sometimes characterized by difficulty falling asleep, drinking alcoholic beverages becomes a common remedy. However, this is a short-term effect, because although alcohol consumption can cause rapid sleep, it is also common to alter the rhythms of sleep, it is also common for it to disrupt circadian rhythms and cause states of wakefulness. and cause states of wakefulness in the middle of the night.

Use of antidepressants in the treatment of alcoholism

As we have said, alcoholism and depression are phenomena that often go hand in hand. In addition to this, various symptoms caused by alcoholism have been treated by various pharmacological prescriptions. prescriptions.

Although the use of anxiolytics is more frequent, since anxiety is considered one of the main causes of alcoholism, the use of antidepressants has recently been studied in the detoxification phase of alcoholism treatment. This phase consists of eradicating psychological dependence on alcohol.

For example, trazodone, which is an antagonist and serotonin reuptake inhibitor, is used for the treatment of alcoholism. is 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.

Bibliographic references:

• Hall-Flavin, D. (2018). Why is it bad to mix antidepressants and alcohol?. Mayo Clinic. Retrieved August 15, 2018. Available at https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-alcohol/faq-20058231.
• Gutiérrez, J.A., Torres, V.A., Guzmán, J.E. et al (2011). Pharmacological therapeutics. Antidepressants. Aten Fam 18(1): 20-25.
• Herxheimer, A. and Menkes, D. (2011). Drinking alcohol during antidepressant treatment- a cause for concern?. The Pharmaceutical Journal. Retrieved August 15, 2018. Available at https://www.pharmaceutical-journal.com/news-and-analysis/drinking-alcohol-during-antidepressant-treatment-a-cause-for-concern/11091677.article?firstPass=false.
• Dualde, F. and Climente, M. (2006). Chapter 03: Antidepressants, pp. 93-147. In Handbook of Psychopharmacology. Retrieved August 15, 2018. Available at https://www.researchgate.net/profile/Fernando_Dualde_Beltran/publication/321997690_Antidepresivos/links/5a3d65fba6fdcce197ff7bff/Antidepresivos.pdf.
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