Ethanol and alprazolam interaction?

[Mafioso]

This is just based off anecdote, but when I drink alcohol without a sedative, my heart starts to race, it gets hard to breath, I get a headache, tired, and overall unenjoyable.

When mixed with sedatives/downers, particularly alprazolam, the effects become much more enjoyable and managable, as I"m a lightweight when it comes to alcohol.

Is this just caused by slowed CNS/heart rate? Note, I haven't been tested, but highly suspect I am on the low end for alcohol dehydronase, hence flushed face and increased sensitivity for an average male my height and weight.

 

[Xorkoth]

Ethanol is a very promiscuous molecule, it has effects on a broad range of receptor types and bodily systems. I sometimes get a raised heart rate and stimulation from alcohol too, though a heavy dose will make me pass out. It sounds like you have a way more intense reaction than me though. I generally find it relaxing.

Anyway ethanol is primarily a GABA-A agonist, while benzos are positive allosteric modulators at GABA-A sites which is different, not exactly sure how though. So they definitely potentiate each other. Amnesia is much more likely when combining them, as well.

 

[AlphaMethylPhenyl]

Ethanol is a POM. It activates the receptor at the orthosteric site, functioning as an agonist. Benzos are PAMs. They change the receptor formation to easier let endogenous GABA (and in this case ethanol) bind to its receptor. These chemicals will synergize. It is not a good idea to take two downers with different nuanced psychodynamic effects, even if they act in aggregate on the same receptor.

OP, it sounds like you might have a mild alcoholism, such that you might be covering up with xanax. This isn't a good idea. I could be wrong, though. It's true that ethanol is a shotgun-type drug wrt what systems it alters. FOr example, there are mean as can be drunks, and perfectly cheery drunks. Again, though, not saying you are. It's just possible. I don't think any doctor wants their patient to drink while receiving benzo therapy, though. Seriously.

Also, people messed up on benzos are notorious for not realziing that they're messed up on benzos.

 

[Mafioso]

a mild alcoholism

This is laughable, I'd withhold your diagnosis as the info was great up to the point.

Poly drug addict, sure. But alcohol is the least favorite, and even though I've been using it lately to potentiate benzos, I've still consumed less than a 12 pack of beer, or alcohol equivalent this entire year. Probably the one of the few drugs that are easy to pass. Thanks for the info tho.

 

[asecin]

ah yes the memories. my first drug induced seizure going way back in the early 00s when i mixed alprazolam and alcohol. i probably continued mixing them for a month or two. yes, it was pretty fun and enjoyable while doing so, until i quit both cold turkey and had some of the weirdest experience back then. now known as seizures, back then i didnt know what it was. it was a complete dissociation from your body and mind and a kind of floating out into space. hallucinations, delusions and psychotic thoughts. i was planning to rape my neighbor for one. also do all kinds of nothing holding you back type of bullshit. i knew it was insane to even think about it, but my body and mind didnt belong to me anymore. it was just on auto pilot and i was stuck in there observing everything acting on impulse. i cant believe i never went through with any of those manic thoughts back then, because i didnt have any control whatsoever. i suppose was just very very lucky. ever since then i have been reading of people commiting all kinds of horrible crimes when mixing those two. but even back then when i joined this forum, still little information was available to prevent the stupidity i did mixing those devil's drugs. also, i remember every doctor i ever visited prescribed me alprazolam from just saying "i dont feel comfortable". even when i was withdrawing from it and thought i was dying, the doctor just gave me 60 pills extra and said i should be fine *sigh*
anyway, DO NOT MIX THOSE TWO! im warning you, you might pay a dire price!

 

[Mafioso]

DO NOT MIX THOSE TWO! im warning you

Thanks for the warning, your seizure was likely caused by the cold turkey of the combo, but I understand it isn't advised.

Was more curious about the interaction, and why it makes drinking enjoyable, when it normally makes me heart race and give me a headache, even one beer. I believe it's due to low levels of alcohol dehydronase, but have nothing beyond anecdote.

 

[nuttynutskin]

I think part of the reason it wasn't that hard for me to give up the booze (for all intents and purposes) was because alcohol just by itself was always more or less take it or leave it for me. Combined with a benzo tho and that was my favorite combination for a good 7 years. I have no idea the scientifics of it tho, but it will wreak havoc on your natural gaba system and cns.

 

[Mafioso]

I appreciate the warnings, but can we stay on topic.. I don't think it's fair to say it will wreak havoc on gaba or cns, as it'd be highly dose dependent. I'm sure it high doses it could, but in low enough doses it could also do nothing at all.

Obviously it can be a dangerous mixture, that's been well established. I'd just like to know more about the pharmacology and physiology of the two drugs. Please stay on topic(neuroscience and pharmacology), i'm interested in the science.

 

[asecin]

whats so difficult to understand. alcohol is complex and it affects the nervous system in many unpredictable ways. its mostly a stimulant but people claim its a depressant. ALL alcohol will stimulate your nervous system even when you do not realize this as in the moment of drunk stupor. you feel pretty down, relaxed etc. but in actuallity its stimulating your nervous system in some nasty ways. especially the heart is most vulnerable to alcohol's stimulation. why you can experience this easier maybe because perhaps you are more sensitive and aware of it unlike others? benzos will always calm down. its their main effect! i shouldnt be giving such advice but im certain you will experience even more pleasure drinking if you add opiates to the mix. in my case, i get utterly sick on alcohol unless i add some type of opiate of any sort. my nervous system is a wreck though. i also use benzos to deal with the stimulative after effect of alcohol even though i try to avoid combining them same time. ill do that afterwards usually. opiates will definately make you love beer even more IF benzos are helping you with this now. i personally have become quite aware of alcohol's nasty ass nervous system stimulation and have adapted opiate coop to deal with it. but its a very very bad idea which im trying to avoid now days.

 

[Mafioso]

its mostly a stimulant but people claim its a depressant. ALL alcohol will stimulate your nervous system even when you do not realize this

What's so difficult to understand? Because you are literally contradicting well known facts. It's not difficult to understand that you are mistaken, but whatever your point is was lost in the first 3 sentences. Maybe it's because my attention span won't allow me to read past it, or maybe I got distracted reading this:
"Like acetaldehyde, alcohol has been widely considered a nonspecific drug, despite rather persuasive evidence implicating inhibitory GABAA receptors (GABAARs) in acute alcohol actions, for example, a GABAAR ligand, the imidazobenzodiazepine Ro15-4513 antagonizes many low-to-moderate dose alcohol actions in mammals."
This is not the mechanism of a stimulant, although it does say nonspecific drug largely because of lack of inhibition from my understanding..... anyways. This thread is fun and productive. I think we can stop here, the first two replies were enough to send me in the right direction to figure it out.

I don't think talking to someone who is convinced ethanol is a CNS stimulant will bring me any closer to my answer....sigh....closed minded but I don't have the energy for this hs

 

[checktest]

Well, getting stimulating effects from alcohol can be a risk factor for alcohol abuse, in context of other things. While GABA/GABArs are generally inhibitory, you can have disinhibition within circuits or more complex effects.

Stimulant alcohol effects prime within session drinking behavior

Individual differences in subjective alcohol effects have been shown to differ by risk status (e.g., family history of alcoholism) and to predict future risk for alcohol-related problems. Presumably, individual differences in both stimulant and sedative ...

www.ncbi.nlm.nih.gov

Stimulant and motivational effects of alcohol: Lessons from rodent and primate models

In several animal species including humans, the acute administration of low doses of alcohol increases motor activity. Different theories have postula…

www.sciencedirect.com

Rewarding, Stimulant, and Sedative Alcohol Responses and Relationship to Future Binge Drinking

Excessive consumption of alcohol is a major problem in the United States and abroad. Despite many years of study, it is unclear why some individuals drink alcohol excessively while others do not. It has been postulated that either lower or greater acute ...

www.ncbi.nlm.nih.gov

GRIK1 and GABRA2 Variants Have Distinct Effects on the Dose-Related Subjective Response to Intravenous Alcohol in Healthy Social Drinkers - PubMed

This study suggests that gene variants contributing to the risk for AUD may alter features of the alcohol dose-response relationship in specific ways. GABRA2 rs279858*C enhances stimulant responses to higher levels of alcohol, while the GRIK1 rs2832407*C-allele increases sedative responses. In...

pubmed.ncbi.nlm.nih.gov

Here two genes with variants are highlighted (GABRA2 and GRIK), highlighting a GABRA2 stimulatory response effect. I actually have that variant (and plenty of alcoholism in my family), and do get the palpitations / notice my heart when I drink. Whether that is the cause I don't know, but it is something to think about. Meanwhile I have a friend with POTS who sometimes drinks when she wants to calm her heart (though I think she gets a rebound tachycardia sometimes and really shouldn't do it.)

A GABRA2 Variant Is Associated with Increased Stimulation and ‘High’ Following Alcohol Administration

Abstract. Aims: Variation in genes encoding GABAA receptor subunits has been implicated in the risk of alcohol dependence (AD). We sought to replicate and

academic.oup.com

Association of Gamma-Aminobutyric Acid A Receptor α2 Gene (GABRA2) with Alcohol Use Disorder - Neuropsychopharmacology

Gamma-aminobutyric acid (GABA) is a major inhibitory neurotransmitter in mammalian brain. GABA receptor are involved in a number of complex disorders, including substance abuse. No variants of the commonly studied GABA receptor genes that have been associated with substance dependence have been...

www.nature.com

It could be the variant causes the receptor to have lower affinity for alcohol, thereby other targets of alcohol could dominate. GABAergic/glutamatergic balance. Could be altered. Or something entirely else.

This is for alcoholism but highlights some candidates. Couple years old but nature reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/

Alcohol-induced alterations in dopamine modulation of prefrontal activity

Long-term alcohol use leads to persistent cognitive deficits that may be associated with maladaptive changes in the neurocircuitry that mediates executive functions. Impairments caused by these changes can persist well into abstinence and have a negative ...

www.ncbi.nlm.nih.gov

Dopaminergic connections. Downstream vs. Direct.

Then there is all that ghrelin and other stuff.