Curious to know about alcohol and Citalopram

[beatroon]

Hi all,

I'm interested to know how many people are completely teetotal when on Citalopram. I'm unsure as to whether I should be giving up alcohol full stop. Does anyone else have any experiences they could share? Or insight as to how the Citalopram and alcohol interact, i.e. does alcohol inhibit the efficacy of the drug?

Just interested to know people's thoughts basically. I do like a glass of wine at the end of the day but perhaps it's not in my best interests to continue…

Thanks!

[MyNameIsTerry]

If alcohol inhibits a drug, they would state you shouldn't consume it. They advise to abstain or reduce on the basis of some possible (and the usual vague side effects in many interactions) side effects.

Heavy consumption could be a different matter though in terms of offsetting benefit.

I asked my GP and he advised moderation was fine. Doctors are realistic, they know alcohol is common in society and that these meds are long term solutions.

Alcohol does have an effect on Serotonin. It causes it to spike. I often wonder whether the next day nightmare some have on here is because of a great reduction I Serotonin that has to be re stabilised taking some time from food consumption.

But we also have elements like stories from people who are struggling badly with anxiety who get drunk and then complain of the hangover. It's just common sense to me that if you panic already at things a non sufferer (or someone well into recovery) you are bound to panic with a hangover. HA people obviously will as they do over things non HAers just put up with.

There are also contradictions. Many anxiety sufferers can tolerate alcohol fine. And since we don't have millions of sufferers reporting alcohol triggers, I tend to assume those that suffer are a lower % for whatever reasons.

I will be interested to read what Ian says (Panic Down Under) as he's one for the science side. I've never looked much into the chemical combination.

[panic_down_under]

I do like a glass of wine at the end of the day but perhaps it's not in my best interests to continue…

Heavy alcohol consumption can significantly reduce antidepressant effectiveness by inhibiting hippocampal neurogenesis, however, a glass of wine in the evening is unlikely to have much impact.

One thing to be aware of for those occasions when you consume a little more is that some find the alcohol-antidepressants combination unpredictable. Some days they could drink a herd of alcoholic elephants under the table without raising a sweat, on others a small drink can turn legs to rubber, so tread carefully until you work out how you react, and whatever you do please don't drink and drive.

[venusbluejeans]

I drink a little while taking Citalopram and have no negative effects. I don't drink to excess and think things may be different effects wise if I did....

of course everyone is different and will react in different ways to alcohol while taking meds

[beatroon]

Thank you, Venus and Panic Down Under. Always good to have others' thoughts and experiences.

I have been reading a bit about hippocampal neurogenesis, and research papers from the last five years on its implication in depression, which are really interesting. Some seem to be suggesting that SSRIs work by increasing neurogenesis, rather than anything specifically to do with the serotonin system (although I may have misunderstood that) - hence the time lag between starting to take them and feeling better. Anyway, that's by the by - the useful thing is to know that alcohol will inhibit this process in large quantities, so I probably do need to be moderate and try to stick to the NHS guidelines!

I've also read up on ways to increase neurogenesis via exercise, mindfulness and diets. As ever, I'm wary about just saying 'oh well if I go running that will cure me' as anxiety and depression are multi-faceted, influenced by our lived environments, unique body habitus etc but I'm all for more information!

[panic_down_under]

Some seem to be suggesting that SSRIs work by increasing neurogenesis, rather than anything specifically to do with the serotonin system (although I may have misunderstood that) -

There is a lot of evidence supporting neurogenesis as the underlying mechanism, but a lot of the 'how' still needs to be worked out. We'll probably have a much better understanding in 50-100 years provided we don't fry ourselves first.

Serotonin is only one factor among many. Non serotonergic antidepressants work as well as those which act on serotonin, and serotonin reuptake enhancers work are at least as effective as the more common inhibitors. Therapy, exercise and Omega-3s, particularly eicosapentaenoic acid (EPA) work too. Genetically modified mice unable to synthesize more than trace amounts of serotonin are no more likely (http://pubs.acs.org/doi/abs/10.1021/cn500096g) to be depressed than the controls and are less anxious (http://dx.doi.org/10.1038/tp.2012.44) too.


I'm wary about just saying 'oh well if I go running that will cure me' as anxiety and depression Exercise can be very effective for mild anxiety/depression and can be a valuable support to other treatments in more severe cases. There's no need to run daily marathons either. A good 30 minute walk 4-5 days a week can make a significant difference.

[beatroon]

Provided we don't fry ourselves :) That is the question isn't it!? What you say reminds me of Andrew Solomon's excellent TED talk and book on depression. He says he is glad to be alive now rather than fifty or a hundred years ago, when there wouldn't have been as effective a set of medications available.

Thanks again, Panic Down Under. I'm constantly in awe of how you know the things you know, and it's very interesting and useful to have you to discuss these things with!

---------- Post added at 12:26 ---------- Previous post was at 12:21 ----------

PS Just had a look at that paper in Nature that you recommended. I love that one of the tests for MHI in mice is to do with marble-burying. I think we anxious types quite often feel that we're constantly, unsuccessfully trying to bury marbles, but not sure why we're doing it! :)

[MyNameIsTerry]

Ian,

What do you make of the EPA science? I've spent time looking at this and found that studies are mixed but I take this as an interesting sign because it doesn't answer the question that it can't work.

I suffered mood imbalance for years due to Duloxetine. I went on Omega 3 and only went a few hundreds mgs of EPA > DHA and 5 weeks was enough to see a substantial change. The anxiety blips I have suffered in a cyclical fashion continued, and initially heightened for a couple of times, but the depression crash after them didn't come.

Then Later that year after being stable for about 8 months, I got lazy over Xmas and didn't take any for about 3 weeks. When the blip came, so did the depression. A week back on the EPA and that balanced back out again.

I've been taking it a couple of years now and my mood is still balanced. I stopped comparing to others and getting upset that I was suffering too. This was my work too but the Omega 3 played a part.

---------- Post added at 12:28 ---------- Previous post was at 12:27 ----------


PS Just had a look at that paper in Nature that you recommended. I love that one of the tests for MHI in mice is to do with marble-burying. I think we anxious types quite often feel that we're constantly, unsuccessfully trying to bury marbles, but not sure why we're doing it! :)

So, the mice hadn't lost their marbles after all? :whistles::yesyes:

[beatroon]

I also take Omega 3, trying to stick to the balance of EPA/DHA recommended in The Depression Cure. I do notice that if I stick to it, the 'compare and despair' thing goes away, and I feel more able to be satisfied with things are they are, more generally relaxed, but wasn't sure whether it was mainly placebic. I guess either way it's fine!

[panic_down_under]

What you say reminds me of Andrew Solomon's excellent TED talk and book on depression. He says he is glad to be alive now rather than fifty or a hundred years ago,

Too true. Back in the early 1960s I went with my father to visit one of his employees who'd been admitted to a psych hospital for severe depression. Not a pleasant experience for anyone involved, not least because there weren't any effective treatments. The place almost reeked of despair. The MAOIs and TCAs were still a couple of years from market.

Nearly 30 years years later I spent a month in a psych ward of a major general hospital myself after developing panic disorder. It was a much more constructive experience because they now had effective, reasonably well tolerated TCAs with the SSRIs beginning to appear in Europe.

Thirty years on again and the psych hospital was demolished long ago as few now require long-term inpatient care and the psych ward now specializes in eating disorders which are the only disorders that do still require long inpatient stays. We still have a long way to go, both drugs and therapy are still fairly crude treatments, but we have come a long way in the last 60 years.

[Catherine S]

I guess it's weighing up the pros and cons of these meds. I already take beta blockers which have some side effects but the benefits outweigh the negatives, but today ive also been prescribed Ramapril for high BP, after trying unsuccessfully to control it myself for best part of the last 10 years, and now the time has come to treat it medically.

As my doc said, it's whether you want to live longer on the meds and accept the side effects if they come, or don't treat it and risk high BP reducing your lifespan. So it has to be the meds. But I get that there wouldn't have been a choice at all in the not so distant past, so I'm grateful to have options these days :)

ISB

[panic_down_under]

I've been taking it a couple of years now and my mood is still balanced.

I've been taking 6 x 1,000mg fish oil capsules for about 11 years, not for anxiety, but for my heart. I had my left lung removed and as the lungs act as shock absorbers for the cardiovascular system it is now under more strain than usual. I can't say whether it has also has any impact on anxiety as this is well controlled by my antidepressant, but the Omega-3s do seem to help a lot of people.


So, the mice hadn't lost their marbles after all? :whistles::yesyes:

No, but from whom did they get the marbles in the first place? Are you missing any Terry, because my "friends" insist I definitely am. :winks:

[Batman]

I think people differ, it affects me so I don't drink. Been on citalopram for about 3 years now too. Maybe it's because me and drink have had a rocky past, or maybe it's just the medication, I dunt know

[varucasalt]

Do not drink on Citalopram Ive been on it for 17 switch to effexor. It makes you feel so very depressed and anxious the next day.

[WiredIncorrectly]

I drink about 3/4 pints most nights whilst on citalopram. It's probably why I'm feeling so rough on these meds. 3 years ago I had a nasty reaction when I was on 40mg that prompted me to go straight to ER. I was fine, but that wasn't a nice experience.

[panic_down_under]

I drink about 3/4 pints most nights whilst on citalopram. It's probably why I'm feeling so rough on these meds.

It may well be. Alcohol inhibits neurogenesis, the mechanism by which antidepressants create the therapeutic response. Also, while alcohol is the most (self)prescribed anti anxiety 'med' on the market, it actually makes anxiety (also depression) worse over time. Alcohol and anxiety/depression feed of each other in a vicious cycle.

[WiredIncorrectly]

It may well be. Alcohol inhibits neurogenesis, the mechanism by which antidepressants create the therapeutic response. Also, while alcohol is the most (self)prescribed anti anxiety 'med' on the market, it actually makes anxiety (also depression) worse over time. Alcohol and anxiety/depression feed of each other in a vicious cycle.

I do believe there's a lot of truth in that.

[Supernova]

Doesn't it not mix well with your heart if you drink on celexa?

[WiredIncorrectly]

Doesn't it not mix well with your heart if you drink on celexa?

There's no evidence to suggest that drinking in moderation on Citalopram/Celexa is dangerous or bad. The only thing I notice is after a couple of beers I feel very sleepy. It mentions this in the leaflet you get with the meds. The hangover the next day is horrible though. You may also be susceptible to increasing your anxiety and depression if you drink.

[Supernova]

I drank Saturday and was fine and slept well. Drank yesterday on Mother's Day and had an awful night

[Andy1718]

Been on cit for over 8 months and never had any issues with drinking on them. Keep in moderation though.