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.
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