Celexa and Adderall XR in am... a beer in the pm?
January 31, 2016 11:10 PM Subscribe
Posting for someone else (really!). He takes doctor-prescribed Celexa 20mg and Adderall XR 20mg around 8am. He has been on the Celexa several months and is fine having a beer or two in the evening, maybe once or twice a week at the absolute most, with no side effects. Even the doctor thought that was OK. Now he's on Adderall XR as well and unsure if he can still have the occasional beer.
The doctor is less fine about this given all of the Adderall warnings, but has no real concrete answer as to when/how much/how often is in a safe range. He has not had any alcohol since starting the Adderall and is fine not drinking if that is what is required to be safe, but would prefer to be able to have a beer now and then in very minimal quantities.
Main question: Is that safe? Does a beer or two around 12 hours later affect the drugs' possible side effects, or increase/decrease efficacy of either drug? Most of what we have read online refers to mixing Adderall and alcohol (taking them together), binge drinking with Adderall, or young people taking unprescribed Adderall and drinking. None of these apply here.
Relevant details:
-Meds are taken around 8am, beer would not be consumed until maybe 6pm at the earliest, usually later
-Adderall XR is the extended release, but still only has noticeable effect to him for about 5 hours
-He is 6' 1", appx. 220 pounds. Age is mid 40s.
-It's possible he'll need to have the dose of Celexa or Adderall XR increased at some point, but for now is steady with the current doses
-"A beer or two" really just means about a pint (or a can) or two, and "once, maybe twice, a week" really just means once, maybe twice, a week. I am not asking this question as some kind of green light to drink a ton.
-He does not drink and drive or do other dumb stuff
-No other health problems aside from high cholesterol (and the obvious depression and ADHD)
The doctor is less fine about this given all of the Adderall warnings, but has no real concrete answer as to when/how much/how often is in a safe range. He has not had any alcohol since starting the Adderall and is fine not drinking if that is what is required to be safe, but would prefer to be able to have a beer now and then in very minimal quantities.
Main question: Is that safe? Does a beer or two around 12 hours later affect the drugs' possible side effects, or increase/decrease efficacy of either drug? Most of what we have read online refers to mixing Adderall and alcohol (taking them together), binge drinking with Adderall, or young people taking unprescribed Adderall and drinking. None of these apply here.
Relevant details:
-Meds are taken around 8am, beer would not be consumed until maybe 6pm at the earliest, usually later
-Adderall XR is the extended release, but still only has noticeable effect to him for about 5 hours
-He is 6' 1", appx. 220 pounds. Age is mid 40s.
-It's possible he'll need to have the dose of Celexa or Adderall XR increased at some point, but for now is steady with the current doses
-"A beer or two" really just means about a pint (or a can) or two, and "once, maybe twice, a week" really just means once, maybe twice, a week. I am not asking this question as some kind of green light to drink a ton.
-He does not drink and drive or do other dumb stuff
-No other health problems aside from high cholesterol (and the obvious depression and ADHD)
Your post got me interested in the effects of alcohol on heart rate and blood pressure. I had thought that in the short term alcohol would lower them, but (from a search on PubMed) it turns out that's not true: when we drink, our pulse and blood pressure rise a little. Psychostimulants like Adderall can cause mild increases in heart rate and blood pressure that persist in between doses. Your friend's drinking style and his medication doses are modest; but he's not so young any more, and he has high cholesterol, so he has a couple of cardiovascular risk factors. And he seems to care about being prudent and cautious with his health.
Altogether, I think the risk is not a big one, but it's real, and impossible to quantify. One option might be to play around with a home blood pressure device and see what the pulse and blood pressure do in response to one drink. That could be fun and interesting, in any event!
But, that really only lets you measure a couple of aspects of the strain that the combination of substances puts on the body. What about heart rhythm problems, for example? The FDA now limits dosing of Celexa to no more than 40 mg, due to a particular arrhythmia risk; and both psychostimulants and alcohol can cause arrhythmias, sometimes at modest doses.
I've been watching the data about the risks of brain-active substances for more than 20 years, and the trend goes in one direction only: we always gradually find out that the risks were higher than we thought. (The only exception I know of is with caffeine, which keeps on looking pretty darn good.) And also, every person is unique--a veritable universe of unknowns.
Best of luck to your friend, and thanks to you for posting an interesting question.
posted by seacats at 4:01 AM on February 1, 2016 [1 favorite]
Altogether, I think the risk is not a big one, but it's real, and impossible to quantify. One option might be to play around with a home blood pressure device and see what the pulse and blood pressure do in response to one drink. That could be fun and interesting, in any event!
But, that really only lets you measure a couple of aspects of the strain that the combination of substances puts on the body. What about heart rhythm problems, for example? The FDA now limits dosing of Celexa to no more than 40 mg, due to a particular arrhythmia risk; and both psychostimulants and alcohol can cause arrhythmias, sometimes at modest doses.
I've been watching the data about the risks of brain-active substances for more than 20 years, and the trend goes in one direction only: we always gradually find out that the risks were higher than we thought. (The only exception I know of is with caffeine, which keeps on looking pretty darn good.) And also, every person is unique--a veritable universe of unknowns.
Best of luck to your friend, and thanks to you for posting an interesting question.
posted by seacats at 4:01 AM on February 1, 2016 [1 favorite]
Anecdotage: I take no Celexa, but lots more Adderall XR than your friend. Also some Wellbutrin and a small dose of a benzo at night. My psych meds prescriber has very few concerns about my having a drink now and then. I do have familial hypertension as well as the typical increase from the Adderall, and am on a small dose of losartan. GP is not worried about me having a drink now and then.
However, I will say that I don't drink more than once a month because due to genetics and meds I have almost no tolerance at all (and expensive taste in wine that I can't drink fast enough). So I echo Superplin about taking it very easy at first.
posted by monopas at 8:45 AM on February 1, 2016
However, I will say that I don't drink more than once a month because due to genetics and meds I have almost no tolerance at all (and expensive taste in wine that I can't drink fast enough). So I echo Superplin about taking it very easy at first.
posted by monopas at 8:45 AM on February 1, 2016
I'm on Adderall XR and have always understood the main concern to be that mixing a stimulant with alcohol can mask the effects of the alcohol, and the lack of warning signs might lead one to consume more alcohol than normal, even dangerous amounts, without feeling the normal effects as quickly as usual. But a beer (or even two) in the evening, when most of the effect of the Adderall has worn off (and as others have pointed out, it's a low dosage) probably isn't going to harm him.
My experience has been, however, that drinking even a small amount of alcohol later in the evening (say, after eight or nine PM) can mess with normal sleep patterns, which in turn can cumulatively affect focus and mood, so if he's going to have a beer, maybe he should consider having it early in the evening and make sure he's well hydrated before he goes to bed.
Treating depression and/or ADHD tends to be kind of a whole-life thing...one can't necessarily just take a pill and forget about them, because one's other habits can undermine the benefits of one's medication even if no adverse interactions are involved.
posted by tully_monster at 2:50 PM on February 1, 2016
My experience has been, however, that drinking even a small amount of alcohol later in the evening (say, after eight or nine PM) can mess with normal sleep patterns, which in turn can cumulatively affect focus and mood, so if he's going to have a beer, maybe he should consider having it early in the evening and make sure he's well hydrated before he goes to bed.
Treating depression and/or ADHD tends to be kind of a whole-life thing...one can't necessarily just take a pill and forget about them, because one's other habits can undermine the benefits of one's medication even if no adverse interactions are involved.
posted by tully_monster at 2:50 PM on February 1, 2016
I take Adderall XR and Wellbutrin XR in the morning and Celexa at night. I also have a couple of glasses every evening. Hasn't killed me yet!
posted by Jacqueline at 9:08 PM on February 1, 2016
posted by Jacqueline at 9:08 PM on February 1, 2016
This thread is closed to new comments.
Except for the first couple of months, when it took me a while to figure out why I got tipsy so much faster than usual, I've had no problems of any kind with the occasional beer/wine/cocktail, and I'm a lot smaller than your friend. So he might want to limit himself at first to see how he responds, but other than that I wouldn't worry too much unless his drinking becomes more frequent.
posted by Superplin at 11:26 PM on January 31, 2016