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Mental Health Other drugs impairing SSRI efficacy

etcccc

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I am going to keep this short and sweet, because I am honestly pretty low on motivation right now. But I was wondering if anybody was aware of a pharmacological explanation for why regular drinking while taking an SSRI will destroy its efficacy.

Also, and kind of more importantly, I was wondering if anyone had any knowledge or first-hand experience as to whether taking occasional doses of Adderall (like once weekly) would impair its efficacy as well. Any help would be greatly appreciated, cheers.
 
OK, so it seems I have more motivation than I thought. Just to provide a little more backstory and explain what my situation is about. So, I've been on Zoloft for about the last four months (currently at 200mg). Suffice it to say it seemed very promising in the beginning, but it was very up-and-down, and there were a variety of issues that I think lead to impaired functionality (namely, it severely disrupted my sleep at points, and lead to over consumption of caffeine and Advil (which can apparently disrupt it's efficacy as well). I tried getting those factors under control, and eventually did. I continued to wait it out from there, but the situation had been dire for a long time, and after enough time of it still not working that well, I basically lost my shit.

I started drinking, about two months ago, only occasionally at first, but more recently it has become almost daily and sometimes quite heavily. I know that this is negatively impacting whatever chance the Zoloft might still have of working, (not to mention just negatively impacting me in general), but I've been pretty hopeless and lately have just kind of lost control. re the pharmacology question, I guess I'm just curious as to what the possible mechanism might be so I could better understand the extent to which this is affecting my medication. I'm also equally, or honestly moreso interested to hear anyone elses subjective experience with this as an issue. The more details the better. I know that the ideal route is to not drink at all. But I don't know if I can do that right now, and on some level I'd like some level of insight into precisely how destructive it is. I know that's kind of an impossible question. I don't expect a perfect answer. But namely, I don't know whether to caterigcally blame the medication's lack of efficacy on the drinking (because it had had points where it started to work, but for all I know these were just placebo, because they were weirdly few and far between) or whether I might just genuinely need to switch to another med and/or add an adjunct. I am extremely hesitant to switch, however, as the Zoloft has definitely had some positive effect, and other SSRIs I've tried in the past were sometimes quite negative, and given how unstable I am right now, I can't risk getting any worse.

The Adderall question is honestly more pressing to me, however. I've always had an extremely positive relationship with Adderall. I find it to be extremely therapeutic, and during the periods of time I take it, as I said, I do so in moderate doses about once a week as a way to get my shit together. I haven't' t taken it in over a year (in fact I've been clean from basically everything since the last year (and continue to be recently, other than the alcohol, obviously). But I've been trying to locate it (adderall) this last month and have just succeeded. I feel pretty confident that I could use it, once weekly, in order to get off of alcohol completely. I've never even liked alcohol, honestly, but it's just the only substance I've had access to. But I feel confident I could use the Adderall in a much healthier way, to get some of my motivation back and be productive, if only occasionally, and hopefully to help make it through this extremely difficult time while I wait and continue to give these SSRIs a chance and/or to switch to or to add a new one. But I'm concerned that even this minimal Adderall use would disrupt their efficacy. And I'm curious if anyone has any first-hand experience with this issue as well. Does taking any recreational drug, just in general, impair an SSRI from being able to work? Even if you only take it occasionally and in moderation? Is there even a definitive answer to this in the literature? I know this is all a gray area, fundamentally. It all comes down to the drug, and the individual, and the frequency and intensity of use. But based on what I've described of my proposed pattern, if anyone has had a similar one, I'd really like to hear about it. I'd be immensely grateful for any advice or details that you could give me on this issue. Thanks guys!
 
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I've never noticed alcohol impairing SSRI efficacy, either in myself or others on it. I think it's just you. But I really don't think sertraline is the optimal SSRI for you based on your post & would definitely try switching if I were you, to fluoxetine or citalopram.

As for Adderall, unfortunately the SSRI will reduce ITS efficacy. How much is unpredictable, but for me it wasn't worth taking on SSRIs. Just a waste. I hope you have better luck. I also find it very functional used occasionally.

Lastly, I think this thread is probably more suited to the Mental Health forum, but I'll leave that up to the mods.
 
I've been prescribed SSRIs with some form of ADHD medication (Ritalin, Focalin, Adderall, Concerta) for years, and for me they didn't make any noticeable impact on any SSRI (I've been on Zoloft, Prozac, and Lexapro) however I felt much better and less depressed bc the stim. Alcohol feels like hell on earth to me now and it was still absolutely awful when I was just on Zoloft.
 
My psych told that drinking more than 6 units of alcohol "washes" the serotonin out of your brain, which would negate the Zoloft.
I told him that must be wrong because I was one of those people who was always really happy while drunk. He said it was impossible :/...I think it must be something to do with the GABA.
 
Alcohol and antidepressants don't mix. As I'm reading the initial post, I can say from experience that 200mg Zoloft extremely helped me but it turned out that other antidepressants (and antipsychotics and mood stabilizers used in my case to treat depression) work much better. Lexapro and Prozac also did absolutely nothing even at max dosage like Zoloft did for me. If it's helped you a lot and you don't want to get off of it maybe you could talk to your doc about an adjunct like Abilify or Seroquel with it. But alcohol would interact with those a lot more than Zoloft alone
 
you can research if alcohol or amphetamine affect enzymes relevant to ssris or whatever. that shouldn’t be hard to figure out and the writing of your post suggests you’re capable of doing so. you wouldn’t have to read further than the free abstracts to find your answer, peer reviewed and all. (wow, searched for 5 - 10 minutes before posting and the results are clogged with articles about how ssris impact patterns of drinking, how they affect acute intoxication from alcohol, and how they affect the levels of other drugs. though would think the last bit goes both ways, and neither alcohol nor amphetamine were on the list of substances possibly affected through enzyme-related interactions by ssris in the article i found dealing with plasma levels. but i don’t regularly drink or take an ssri or take amphetamine. if i did, i’d spend more than 10 minutes going through articles. since you’re asking for subjective expierences, i took prozac for a few years in my teens. i drank regularly and took adderall for periods during that time. i believe i evenly felt the effects of prozac whether i was regularly using alcohol or not. i did not take adderall often enough to comment.)

more important is that alcohol and amphetamine and general drug abuse affect mental health. all of them without question negatively affect my mental health. very significantly.

when trying to figure out if a medication will help, reducing the number of variables is important. of course getting sober is a variable. but if you feel better and you’re not sure whether to attribute it to a medication or lifestyle changes, that’s a much better problem than feeling bad.

doing what’s best is much more difficult than knowing what’s best. sucks.
 
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