Anxiety, alcohol and Citalopram

[apm]

I just wanted to gather experiences of us lot on drinking with anxiety, particularly when taking meds.

My anxiety came back last week, and I'm currently on 10mg of Citalopram, to ramp up to 20mg probably next week.

On Friday evening, I had about 5 beers with a friend, a curry, and watched a movie at home. Slept like a log. Last night, went out to the O2, had some beers, a cocktail and a G&T, big meal and watched the new Bond film. Truly awful night, heart beating fast until I sobered up at about 0300, then not alot of sleep after that. The alcohol intake must be about the same, but very different outcomes.

Any thoughts/ experience? I wondered if it was the mixing of the drinks last night, or being somewhere a bit outside my comfort zone?

Cheers!

Alex.

[Fishmanpa]

Do a search here. There are pages and pages and pages and hundreds and hundreds and hundreds of threads and posts on this forum that echo the negative effects of alcohol on one's anxiety. Add to that the fact that drug manufacturers warn you about alcohol consumption while taking the meds and you have a combination that's a negative experience waiting to happen.

Positive thoughts

[uru]

I just wanted to gather experiences of us lot on drinking with anxiety, particularly when taking meds.

My anxiety came back last week, and I'm currently on 10mg of Citalopram, to ramp up to 20mg probably next week.

On Friday evening, I had about 5 beers with a friend, a curry, and watched a movie at home. Slept like a log. Last night, went out to the O2, had some beers, a cocktail and a G&T, big meal and watched the new Bond film. Truly awful night, heart beating fast until I sobered up at about 0300, then not alot of sleep after that. The alcohol intake must be about the same, but very different outcomes.

Any thoughts/ experience? I wondered if it was the mixing of the drinks last night, or being somewhere a bit outside my comfort zone?

Cheers!

Alex.

It's weird, sometimes I'll wake up with palpitations after drinking and other times I'll sleep fine. I dunno if there is a common reason.

[MyNameIsTerry]

It's incorrect to state that all drug manufacturers warn about meds with alcohol, you have to look at the specific med. If you check on Drugs.com you will see many say to abstain BUT if you actually look at the interaction function it will explain how it ONLY a Moderate interaction and drinking alcohol should be limited or abstained from.

I even asked my GP, and others on here have too, to hear that moderate drinking is ok. In my case I was in a much better place by then and I actually drank heavily for 5 nights in a row and experienced no issues whatsoever. If I had done that was I was not in a good recovery position, it would have ended with anxiety for me BUT eating food did too and even drinking water.

FMP is right, there are many threads & posts BUT there are also ones like mine so we need to have some balance there. However, isn't this the same argument for antidepressants? We have threads on here saying how CBT made people worse, do we all avoid that? We have caffeine threads too like the alcohol debate but no one seems to stop to ask themselves why we can't find many thousands of threads stating how we all had a lovely cup of tea with no impact to our anxiety. I had 2 today, so perhaps I should raise 2 threads to proclaim it? This is known as Confrimation Bias in psychology and something anyone performing tests, studies, etc always has to rule out to avoid introducing a bias and causing their studies to fail.

It's obvious that the FACTS you posted on here that you have two completely opposing outcomes, it is not the case that "anxiety & alcohol" don't mix for you. I think you need to perhaps look at how you use it i.e. reduce or stick to things that are less of an issue right now. Bare in mind that alcohol is a CNS depressant and blocks Serotonin, which you are taking a med for to prevent wastage.

[apm]

Thanks Terry, that's helpful. I think I will avoid alcohol until things have stabilised. I do known from my last time going through this that once I am stable, then I can drink as I could before. I guess there is a temptation in some ways to self-medicate, for me in particular to get some sleep!

[Fishmanpa]

I think I will avoid alcohol until things have stabilised.

:yesyes: And even then... be very careful! Alcohol and Citalopram can cause/increase negative side effects from the drug.

Positive thoughts

[Justinian]

Teetotal 13 months and one week now. But I'm kinda sleepy now. Hard to focus on this post. I need my eyes tested again (or my stomach pumped?).

[xvolatileheart]

I regret it every time I drink. I feel awful for a few days afterwards. I had a big night on Saturday and I'm still feeling dreadful and regreting it so much.

Should also note: I'm on citalopram 30mg. I threw up my dose yesterday due to the hangover so that surely isn't helping the anxiety.

[Justinian]

I regret it every time I drink. I feel awful for a few days afterwards. I had a big night on Saturday and I'm still feeling dreadful and regreting it so much.

Should also note: I'm on citalopram 30mg. I threw up my dose yesterday due to the hangover so that surely isn't helping the anxiety.

It's my works do early next month and I'm crapping it. Does anyone have a good excuse? I'm considering bubonic plague, Ebola Virus, leprosy or admitting to becoming a new member of UKIP as an excuse not to attend.

[MyNameIsTerry]

It's my works do early next month and I'm crapping it. Does anyone have a good excuse? I'm considering bubonic plague, Ebola Virus, leprosy or admitting to becoming a new member of UKIP as an excuse not to attend.

Ah, the "enforced fun" that is the works Xmas do. I used to enjoy them before my anxiety but after it started it was a different issue as I struggled with eating in social situations as I felt that nausea/need for escape sensation.

Just remember, anxiety disorders are medically recognised conditions as as such if your anxiety is affected by a works event, an employer has to consider whether it is appropriate for you. So, they could just let you off going...and lets face it, who cares? It's just a meal and some drinks, often with people you only see at work.

---------- Post added at 05:18 ---------- Previous post was at 05:16 ----------


Thanks Terry, that's helpful. I think I will avoid alcohol until things have stabilised. I do known from my last time going through this that once I am stable, then I can drink as I could before. I guess there is a temptation in some ways to self-medicate, for me in particular to get some sleep!

That would be a bigger worry than the anxiety as you really don't want to bring a problem like that into your life.

I can appreciate how insomnia feels because I've been though it too but it really is a stage you can pass through, albeit hating it all the way. Try to exhaust other methods of helping your sleep and then you could always have a chat with your GP since there are antidepressants that work with sleep.

---------- Post added at 05:33 ---------- Previous post was at 05:18 ----------


:yesyes: And even then... be very careful! Alcohol and Citalopram can cause/increase negative side effects from the drug.

Positive thoughts

You missed the bit afterwards :whistles:

I do wonder about this impact because we all know that antidepressant side effects are supposed to be short term when starting or adjusting. Typically 4-6 weeks when starting. There are reasons for this because of how they are increasing levels of Serotonin in the space and also how they reduce receptor sites (plugging the holes?). After this point, we shouldn't even have side effects, although some people do seem to continue with them (me included with my current med :doh:)

The side effects that can be experienced are listed as:

Using citalopram together with ethanol can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment.

So, many of the side effects we experience when starting or adjusting are absent. I wonder why? I wonder whether it's less about the alcohol & drug combination but more about how alcohol affects the liver? Many of these antidepressants require liver enzymes to eliminate them from our blood plasma and if you slow this process down it causes more of the drug to remain in your blood plasma for longer than the expected duration. There is a half life range involved in these meds, it's not simply "Citalopram's half life is 36 hours" because everybody is different and metabolism is key here, as are renal disorders.

In the case of Citalopram, most of what is eliminated is unmetabolised Citalopram so it would follow that in slowing the liver down, you end up usng more of it. Alcohol places a strain on the liver since it is attempting to eliminate it and it's over a steady period. So, is it more the impact of alcohol on the body that causes the issue?

I know that is the case with Piperine as I've read about it. Piperine is found in black pepper and it inhibits certain liver enzymes hence any meds that those enzymes will eliminate cannot function as well and you end up with more of the drug in your blood plasma for longer than expected. Grapefruit is the same I believe.

So, I wonder whether there is a specific factor involved here.

There is also the fact that the OP has had two opposing events, something which in a trial would see it come out as a failure because something couldn't be proved. Within this though there may be many other factors such as the difference in alcohol, the %'s involved, the time consumed, hydration levels (before and after), length of time between medication dose and this, etc. The length of time between medication could be interesting since at 36 hours Citalopram would be reduced by half. So, if you took one and washed it down with alcohol wouldn't it be the worst time? No, not really because it has to reach peak concentration which is 4 hours to get to 80%. So, until then it is building up and then it will be reducing more until it is eliminated (this would be 32 hours if you minus the distribution phase).

So, for some people the issue could be in timing as well. This is why I believe the issue of alcohol, anxiety and meds to be quite complex and we haven't even discussed anything about specific issues with a disorder, sensitivities, severity levels, etc.