Hi friends,
One of the commonest
questions that I am asked while treating clients is “Doctor, Is it okay to
drink when I am on the medication?” Many others do not ask the question but
assume that it is not okay. Therefore, they skip the dose of the medicine on
the day they intend to drink. So what is the correct approach?
Firstly, the term ‘psychiatric medicines’ or psychotropic
agents refers to a wide group of chemical agents and therefore cannot really be
taken as one group. So, there is no general answer to the above question; it
really depends upon the specific medicine one is on. For convenience sake, let
me divide the medicines into three groups.
The first group of medicines is those that are popularly
known as ‘sleeping pills’. Chemically, these medicines usually belong to the
class of benzodiazepines (and related drugs). They are generally not
recommended to be taken along with alcohol. They have several properties that
are remarkably similar to alcohol itself. This implies that on taking them along
with alcohol, their effects become supra-additive; resulting in extreme
intoxication and potentially depressed functioning of the heart and lungs. This
can occasionally even be fatal. Although a lot depends on the doses of alcohol
and the benzodiazepine in question that is being taken, it would generally be
considered unsafe to combine the two.
The second group of medicines are those that are not
generally regarded as ‘sleeping pills’ and whose primary use is something
different, but they also have a significant sedative effect. A number of
antidepressant and antipsychotic medicines can be considered under this
category. Unlike the benzodiazepines, although these medicines are sedating,
the characteristics are very much different from that of alcohol. Nevertheless,
caution should be exercised while combining these medicines with alcohol.
Excessive sedation may result and can be potentially dangerous in people who
are already medically compromised.
The third group consists of those medicines which have
minimal to no sedating effects, and in any case, has effects that are
qualitatively completely different from that of alcohol or benzodiazepines. They
are generally safe with alcohol use. Missing a dose of this medicine in order
to consume alcohol would be seen as a double whammy – the deleterious effects
of alcohol plus the lack of protective effects of the medicine. A number of
modern antidepressant and antipsychotic medicines belong to this category.
It is important to
understand that alcohol (with or without the medicine) is generally detrimental
in those suffering from psychiatric/ emotional problems of any kind. It might
seemingly make one feel better in the immediate aftermath of drinking, but in
the medium to long term (and in many even in the short term), it is likely to
worsen the existing condition. So if you are worried about the interaction
between alcohol and the medicine, skip the alcohol, not the medicine!
So that was what I had to
discuss this time around. Please let me know if there is anything that you want
me to discuss in particular, by typing in the comments section below.
Write in at stayhappy.prakash@gmail.com
So until next time, STAY HAPPY!
Dr. Sathya Prakash, MD, Dip. CBT
Consultant Psychiatrist, Psychotherapist
and Behavioural Sciences Expert
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