How well will anti-depressants work with moderate alcohol use?

January 12, 2012 7:23 PM

What blood alcohol content will prevent anti-depressants from working?

A friend of mine has clinical depression and she is on an anti-depressant. However, she drinks alcohol on a regular basis. What blood alcohol level or BAC will block the anti-depressants from working?

She usually drinks 1-3 drinks in one sitting, but will get drunk a few times per month. I'm fairly sure that she drinks almost every day.

posted by mtphoto to health & fitness (15 answers total)

Um. We can't answer this without knowing exactly what medication we're talking about, but in general mixing antidepressants with booze is a terrible, terrible idea.
posted by mhoye at 7:33 PM on January 12, 2012 [3 favorites]

"Block the antidepressants from working" is a pretty vague phrase which is hard to attach to any one pharmacological phenomenon. And that's without factoring in that you haven't told us what class of medication she takes, or that both prescription drugs and alcohol affect different people to different degrees.

But, like mhoye says, most antidepressants don't mix well with alcohol at all. And frequent drinking can easily exacerbate clinical depression in those already prone to it. (This is entirely distinct from alcohol being a "depressant," mind you.)
posted by decagon at 7:45 PM on January 12, 2012 [2 favorites]

Alcohol and anti-depressants affect different people differently.

No one on AskMe is going to be able to definitively state "BAC level XYZ" is OK, but BAC level XYZ + .01 is not."
posted by dfriedman at 7:57 PM on January 12, 2012 [4 favorites]

Depending upon what drug she is one, she may not be affecting the efficacy of the drug, she may be causing damage to her liver or other organs. It's really hard for a doctor to say without much info, let alone armchair docs on MetaFilter.
posted by kellyblah at 7:59 PM on January 12, 2012 [1 favorite]

I drank while on antidepressants and so did other people I know. My doctor told me it wasn't terrible as long as I was basically careful. I found that I couldn't tolerate hard liquor at ALL but wine was fine.

Like some others here I think this greatly depends on the person and their individual medication regimen, body make up and conversations with their doctor.
posted by sweetkid at 8:20 PM on January 12, 2012

It may not be a case of it not working, necessarily. For me, Wellbutrin changes the experience of alcohol to 1/4x the enjoyment, 2x the stupid, and 4x the hangover. It still "works" just fine though.
posted by the jam at 8:34 PM on January 12, 2012 [2 favorites]

It may not be a case of it not working, necessarily.

That too actually -- they never "didn't work," but with hard alcohol I got drunk faster. Overall, the antidepressants "worked," no matter how much I did or didn't drink.
posted by sweetkid at 8:41 PM on January 12, 2012

The problem with alcohol and most modern antidepressants (usually SSRIs), as I understand it, isn't of a specific pharmacological interaction.

Rather, alcohol is a powerful depressant. And alcohol abuse is self-destructive behavior. So the question becomes: why take meds if you're going to sabotage their benefit by swimming in the drink? If you want to get better, why are you doing a half-asses job of it?
posted by wutangclan at 8:51 PM on January 12, 2012 [1 favorite]

Are you asking this question because you want to arm yourself when talking to this friend? This may or may not be a good idea, depending on what conversations she's had with her doctor about this. You'll get a lot of "this is self sabotage" answers on this, and those are right a lot of the time and not right a lot of the time. If she has faith in her doctors and therapists, I'd trust her to manage her own treatment.

Only you know your friend, but even if you want to help you may just frustrate her more if you try to intervene, if she feels she has things under control. It's hard to tell from just this question though.
posted by sweetkid at 8:57 PM on January 12, 2012 [3 favorites]

My doctor told me, when I was on an SNRI, that alcohol was disrecommended not because it interfered with the antidepressant's effects, but because your liver is already working extra hard to clear the antidepressant medications, so you only need a small amount of alcohol before you are damaging your liver in the same way a serious alcoholic does. That said, he told me 1-2 glasses of wine a couple of times a week was fine.
posted by lollusc at 8:59 PM on January 12, 2012 [1 favorite]

The correct answer is: No one in this thread knows the specific answer to your question. Only her doctor can gauge the efficacy of the drug and advise about interactions.
posted by Blazecock Pileon at 9:00 PM on January 12, 2012 [2 favorites]

I take an antidepressant every day for the past 3 years. 'Pristiq' I take this medicine and I have had beers until I got drunk. I have not found any physical or phycological symptoms by doing this.
posted by Kilovolt at 9:02 PM on January 12, 2012

Well, I used to take anti-depressives a while back and although I am not really a 'drinker' (I seldom drink) I did have a couple 'out and about' nights those days, during which I did drink, with no ill effect, or at least, none that I could notice.
posted by Trexsock at 11:43 PM on January 12, 2012

When I went onto Prozac about a year and a half ago, I discovered very quickly that I couldn't have even a single beer without becoming stumbling/stupid Jack Sparrow drunk. I didn't touch alcohol for the entire next year until I stopped taking the meds, and I probably did my body and mind a massive favor because of it.
posted by Strange Interlude at 1:35 PM on January 13, 2012

Everyone's body reacts to every medication (and combos) differently.

My own experience was that I could not drink AT ALL while taking Paxil (this was a number of years ago) because it made me horribly nauseous. I have never become nauseous from alcohol itself, and Paxil itself made me faintly dizzy when I first began taking it, but then I was OK. But, I could not drink at all for the entire year I was on the med.

It would seem prudent to me, from the liver-health standpoint, to limit alcohol use while taking a daily med. It is in fact well-established that taking the ostensibly "safe" over-the-counter painkiller Tylenol with alcohol in the system can be VERY toxic to the liver.
posted by RRgal at 6:22 PM on January 18, 2012