alcohol and citalopram adverse reaction help!!

[stefx85]

My friends husband drinks vodka usually, on citalopram, cipramil. He gets extremely aggressive, suicidal. Is this a normal reaction to recreational drinking and using citalopram?

 

[CrazyEngineer]

It's complicated, and I'm trawling through the literature right now. One of the first potential things I can think of is the interaction between alcohol and the cytochrome P450 enzymes in the liver; there are a couple of these (CYP2D6, CYP2C19 and CYP3A4) that are responsible for breaking down citalopram into inactive metabolites. If I recall correctly, regular and/or excessive alcohol use tends to upregulate those enzymes, which may be causing his body to flush out his meds much more quickly than it would normally and precipitating SSRI withdrawal (of which suicidality and intense, irrational anger can often be a symptom). Add to that alcohol's ability to lower people's inhibitions dramatically when they've had a lot, and you wind up with someone who's impulsive, aggressive, and suicidal. This is still just a hypothesis, though; I recommend checking back with people who know more than me to be sure.

 

[stefx85]

That does make allot of sense! Thanks for the insight.
I appreciate

 

[afewletters]

Well, first off..
Alcohol is a depressant. Whereas citalopram are anti-depressants so you can imagine what the brain is going through processing conflicting messages. Citalopram works on regulating serotonin levels in the brain which we believe controls our mood and sleep patterns as well as other stuff.

So whilst that is doing its work, alcohol is in the system which affects all systems in the body from top to bottom. And it's a known depressant so will help to shut down what the tablets are bringing back up. Hence, the side effects.

If he wants to get better then he needs to understand that drinking alcohol and taking anti-depressants will just cause more problems. And with the suicidal rates on anti-depressants high in humans anyway, think what the depressive qualities of alcohol will do to a man who clearly is already very clearly depressed.

 

[stefx85]

I agree that the alcohol is more the problem than anything else adding antidepressants is a recipe for disaster. I have told her that her husband should stop the drinking..
But try telling HIM that...

Noways he's just gambling in my opinion too. . Just wanted to find out if this is a common problem with citalopram. But as you guys say mixing the 2 is a recipe for disaster.. Thx

 

[Mycophile]

Well, first off..
Alcohol is a depressant. Whereas citalopram are anti-depressants so you can imagine what the brain is going through processing conflicting messages. Citalopram works on regulating serotonin levels in the brain which we believe controls our mood and sleep patterns as well as other stuff.

So whilst that is doing its work, alcohol is in the system which affects all systems in the body from top to bottom. And it's a known depressant so will help to shut down what the tablets are bringing back up. Hence, the side effects.

If he wants to get better then he needs to understand that drinking alcohol and taking anti-depressants will just cause more problems. And with the suicidal rates on anti-depressants high in humans anyway, think what the depressive qualities of alcohol will do to a man who clearly is already very clearly depressed.

Except I don't think alcohol being a "depressant" means it depresses people rather than that it depresses respiration, reflexes, etc.

I don't think depressants and anti-depressants counteract eachother because one *can* (if your respond correctly to the right dosage) help someone to be less depressed while alcohol depresses people, because most people like myself don't get depressed when drinking.

I also take lexapro which is an anti depressant and drink sometimes and don't feel my Lexapro is any less effective because of it but maybe Citalopram is different in this regards to Escitalopram which is Lexapro.

 

[afewletters]

It's actually quite contrary to what you say mycophile. Alcohol is a depressant as if in, it can and will cause depression.

Even though everyone drinks to have a good time, alcohol messes around with chemicals in our brain much like anti-depressants do but in the opposite fashion. Hence why you get a contrasting spectrum of conditions from drinking alcohol from the benine to severe in terms of neurological disorder. But we all know the dangers of drinking and that's without taking anti-depressants.

The mind is a fragile piece of art. We can go over our painting time and time again, but once we choose the wrong colour and too much if it, it can cause everlasting damage. Alcohol and anti-depressants just don't mix, period. It's like mixing matches with petrol and pretending like the matches won't light a fire. If your drunk, you may fool yourself into believing it but the reality is, its a harmful combination.

I'm not saying once or twice here and there having a drink on then will cause long term damage. But sustained mixing of the two combinations is obviously not a good idea. Most of us know not to mix alcohol with medication no matter what it is. Alcohol just doesn't go down well with a lot of things, citalopram is unfortunetly on that list of bad combinations.

 

[Mycophile]

It's actually quite contrary to what you say mycophile. Alcohol is a depressant as if in, it can and will cause depression.

Even though everyone drinks to have a good time, alcohol messes around with chemicals in our brain much like anti-depressants do but in the opposite fashion. Hence why you get a contrasting spectrum of conditions from drinking alcohol from the benine to severe in terms of neurological disorder. But we all know the dangers of drinking and that's without taking anti-depressants.

The mind is a fragile piece of art. We can go over our painting time and time again, but once we choose the wrong colour and too much if it, it can cause everlasting damage. Alcohol and anti-depressants just don't mix, period. It's like mixing matches with petrol and pretending like the matches won't light a fire. If your drunk, you may fool yourself into believing it but the reality is, its a harmful combination.

I'm not saying once or twice here and there having a drink on then will cause long term damage. But sustained mixing of the two combinations is obviously not a good idea. Most of us know not to mix alcohol with medication no matter what it is. Alcohol just doesn't go down well with a lot of things, citalopram is unfortunetly on that list of bad combinations.

It CAN cause depression, but doesn't always.

I'm not going to RECOMMEND drinking on antidepressants, but I've just personally found that for myself the admonitions have never really stood up to the test.

To be honest, I've never in my life drank alcohol OFF of antidepressants considering that I was prescribed Prozac at age 14 and never had alcohol till age 18 and I'm now on Lexapro in my 30s. Though I am not a serious alcoholic but I have certainly done a lot of binge drinking.

When I talked to my last psychiatrist about it he told me it was recommended against which I told him I'd always known that but never found it to be true and asked him what specifically could happen since I'd never heard of anything serious. He wasn't actually able to even give me a good answer and just settled on saying "well I'm not going to tell you that you WON'T have any side effects".

To be honest, if there's anything I'm concerned about (which I'm not really very much) it is having used SSRIs for such a long time and not ever having combined alcohol with them.

It's never effected how they've worked for me or led to any health issues I'm aware of.

It's just really that SSRIs are not usually serious CNS depressants, so mixing them with alcohol is usually not AS dangerous as, say, drinking on Opiates or benzos both of which can kill you and I think MOST of the admonitions are probably because SOMETIMES SOME antidepressants can make you drowsy and alcohol may intensify the effects. In my experience with Prozac and Lexapro it hasn't been true.

But of course alcohol itself is a very harmful substance and a person certainly CAN have extra side effects from drinking on SSRIs, I just happen not to be one of them.

 

[Johndoedoe.junk]

I used to drink while being on Prozac, Welbutrin, and Gabapentin and while it didn't kill me, bad things would definitely happen. I used to black out A LOT and get very belligerent. Granted becoming belligerent while on alcohol can be a very common thing even among those not mixing with meds, I believe in my situation the meds made it happen a lot easier, with less alcohol, and more frequently. As has been pointed out already in this thread, I think the moral of the story is mixing meds and alcohol just isn't a good idea, especially psych meds in my opinion.

 

[afewletters]

But you've been on anti-depressants since 14 and now 30 so that's 15 years give or take and you've never not drank whilst on them? Can you not see the message there?

Anti-depressants attempt to regulate neurotransmitters in our brain. Alcohol disturbs that process and overpowers the anti-depressants rendering them useless and a catalyst towards potentially increased negative side effects. Increased anxiety, irrationality, irritability, aggressiveness are all symptoms of drinking alcohol and coincidently are side effects from anti-depressants if looked at in the right context. So your dancing with fire here.

If you've never been able to state your health without drinking alcohol and taking anti-depressants then its barely anything to go off.

Depression can be an endless loop with the owner of the depression being the one creating that very loop.

 

[Mycophile]

But you've been on anti-depressants since 14 and now 30 so that's 15 years give or take and you've never not drank whilst on them? Can you not see the message there?

Anti-depressants attempt to regulate neurotransmitters in our brain. Alcohol disturbs that process and overpowers the anti-depressants rendering them useless and a catalyst towards potentially increased negative side effects. Increased anxiety, irrationality, irritability, aggressiveness are all symptoms of drinking alcohol and coincidently are side effects from anti-depressants if looked at in the right context. So your dancing with fire here.

If you've never been able to state your health without drinking alcohol and taking anti-depressants then its barely anything to go off.

Depression can be an endless loop with the owner of the depression being the one creating that very loop.

In terms of "message" you mean of course that it's not good to recommend it to others when it might possibly have side effects for them?

Sure, that is why I said I certainly would not suggest it to others.

But what you say about "rendering the anti depressants useless" has not at all been the case with me.

First of all, I take them mostly for OCD/anxiety and not as much depression, but I have had some depression and they still work for that purpose regardless of any drinking I've done.

i don't drink every night, or every other night even, in fact now I haven't drank at all for the past month or so, but it's never been an issue for me.

That doesn't mean it COULDN'T be an issue for others, but I don't believe the claim that my medication is "useless" because I sometimes drink on it.

And I actually asked my last psychiatrist and he admitted that drinking would not probably make the medication less effective for me, but warned me that there could be side effects, which I have not seen any of so far.

If I do see any, I'll have to consider lowering my dosage because I don't see myself NEVER drinking alcohol.

But I drinking never created the anxiety/OCD I had prior to taking prozac at age 14, since I never drank back then, and I don't think therefore I perpetuate those issues by occasionally drinking.

So because of my experience I PERSONALLY do not feel that mixing alcohol with SSRIs is as dangerous as say, mixing it with opiates or benzos, which can actually be life threatening.

But I still wouldn't tell anyone else to do it, I'd tell them IF possible to at least try to LIMIT their alcohol intake and discuss the matter with their doctor, simply because this is an HR site.

 

[Fannytastic]

I'm just about to switch from fluoxetine to citalopram ...I'm planning on not drinking too much (basically just wine with food etc and not getting drunk) on citalopram so this thread is good to read..thanks

Ive had a few wild nights on fluoxetine and alcohol etc and whilst i don't think it altered my depression much or made me aggressive, it made me incredibly sick and weak with major blackouts even on not that much alcohol intake....perhaps something to do with the meds effect on the liver?