Medications & Drinking

There have been several questions about medications, especially in the SSRI group (Prozac, Paxil, Luvox, Zoloft and Celexa), and alcohol.
Although everyone's response to this combination will be different, the best rule of thumb is DON'T MIX THEM.
Here's why:

1) Alcohol and the SSRIs get metabolized in your liver using the same biochemical pathway (called the cytochrome P450 pathway). That means they compete with each other for liver time. While your liver is busy metabolizing the medication so that it's metabolites with help your OCD, the alcohol goes by, largely untouched. This makes you get drunk faster, so that one drink feels like 2-3. Again, some people may find that this doesn't happen to them, but many will.

2) While the liver is busy trying to metabolize the alcohol, the medication goes by unmetabolized. Most of these need to be broken down in order to be active, so you're not getting the anti-OCD, anti-anxiety and anti-depressant effects of the meds you're taking. You might as well be tossing them into the toilet.

3) One of the more recently described effects of these meds is that they make alcohol stay in your system longer. You should NEVER drink and drive, of course; however, many people calculate, using the police recommendations, how long after a drink they need to wait before it's safe to drive. These recommendations don't take SSRIs into account, and you can be legally drunk 3 times longer with these meds in your system than without. I know someone that failed a breath test 6 hours after a single glass of wine (she had to spend the night in jail, pay a $1300 fine, lose her license for 30 days and have a restricted license for 6 months, in addition to doing 40 hours of community service - all for a single glass of wine!!).

4) Alcohol is a central nervous system depressant, and if you're taking these meds for depression, the alcohol can make you more depressed. Also, it takes the brakes off the part of your brain that keep SOME of the obsessions out, so many people find their OCD gets worse. Finally, there is a rebound of anxiety after the alcohol wears off, even for those people that find that a drink calms them down - they report that their anxiety is worse the next day than if they never had a drink!

These seem like pretty good reasons not to mix alcohol and SSRIs.
If you're going to do it anyway, then please do it responsibly (like try it at home first, and know that your anxiety/depression/OCD might be negatively affected, so that you won't be surprised when they are).

dr.(hic!)hat

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