Daily Archives: July 2, 2012

The Psychiatric Cocktail

For anyone who has ever googled something like, “will combining lithium and alcohol kill me?” -we know drinking alcohol while taking psychiatric drugs isn’t reccomended, but is it “safe”?

I realize this is a bit of an odd topic, but it is something I’ve never seen anyone else talk about. I know plenty of people who drink alcohol while taking psychiatric medications for various mental illnesses, and even though doctors always seem to say that we shouldn’t combine these things, they never seem to say outright (at least to me) that we can’t.

Before I dive into this, I know that there are plenty of reasons not to combine alcohol and mental disorders (let alone the medications prescribed for them). I know that for me, alcohol has triggered depression on and off -which (surprise) never quite helps make one the life of the party. Folks with mental illness are also  more prone to develop substance abuse problems, so avoiding drinking might mean avoiding an addiction. Some people use alcohol like an additional medication because of its relaxing/numbing abilities, but these “positives” can quickly be surpassed by such negative effects as liver failure and acting like an all around asshole.

However, some people don’t use alcohol as an escape, and I think it is fair to want to enjoy, say, a flute of champagne at a cousin’s wedding, or a glass of wine at ladies night, or a beer with your woodfired pizza at happy hour. These are the primary reasons I had for searching out this information.

The first time this concern really came up for me was when I began taking lithium at the beginning of last year. I’d taken a couple medications before that, but I was not yet 21 at the time so despite being young, alcohol had not yet made something of a permanent presence within the structure of my social life.

I was overwhelming careful when I began taking lithium, I measured out the amount of water I needed to drink, I documented what happened as the dosage grew higher, and as soon as I could really confirm that the lithium itself wasn’t going to kill me (immediately), I wanted to know if a glass of wine or a beer with the lithium would. 

Again, it wasn’t that I was planning a binge or anything, but as an individual with bipolar disorder who can be impulsive at times (to say the least) I was hoping that planning ahead (or at least having some idea of whether or not this was a terrible idea) would help me out a bit.

The trouble is, each medication acts differently for each person. And alcohol can act differently for each person. And though I quickly concluded that I probably wouldn’t die, my google search revealed little more than the fact that there are a LOT of people out there mixing alcohol with their psychiatric medications.

I think it is really important to be careful, especially when attempting to combine any two substances within the body. I realize that many people would consider me to be overly careful, but I have lost someone in my life due to the grossly twisted painkiller/alcohol beast. NEVER combine alcohol with painkillers or sleeping pills, and I would go so far as to say ALWAYS talk to your doctor or pharmacist before combining any drug with alcohol.

It is also a good idea to:

1. Check the warning label on the medication, some explicitly say, “do not mix with alcohol,” which I would definitely follow. Others say, “alcohol may cause extreme drowsiness,” or “may cause drowsiness, alcohol may intensify this effect,” which could mean any number of things. Alcohol may cause you to black out, become extremely fatigued, or feel more intense than it normally would.

2. Limit the number of drinks you partake in. Some medications, as I will describe below, actually make alcohol quite a bit less fun and relaxing, so it gets really easy (really fast) to drink only one or two drinks.

3. Don’t drink alone. Even if you’ve talked to your doctor about drinking while on your medication, it is a good idea to have another person around in case you have an unexpected reaction, at the very least the first couple times you try it.

4. Do not attempt to drive. Even after one drink, driving is a bad idea since drowsiness can be increased rapidly by many psychiatric medications.

5. Expect the experience to be different. The effect alcohol has on me is almost the opposite as it had before psychiatric medications, and I found the reaction to be very confusing the first few times I had a drink. If the reaction you have is that nothing happens, trying to drink a lot more to counterbalance it is not recommended.

My own experiences have been pretty interesting, and though the following is what I have experienced, I would not expect to experience things the exact same way. Again, medications all act differently for us, so it is very likely that the combination of alcohol with that mix will be quite different as well.

For me, combining alcohol and lithium has been one of the reasons I don’t drink much anymore (for better or worse). Basically, for every one drink I have, I have to drink at least 3 glasses of water. Dehydration and lithium do not mix, so even after one single drink (and the water described) I will wake up with a hang over. The hang over will intensify exponentially with each drink I have, basically, which is a giant bummer. I also feel less intoxicated than I normally would with each drink, which means a much bigger hangover for very little “fun”.

For a time I was taking Lamictal with the lithium, and in conjunction to alcohol the effects from what I experience with the lithium were intensified. I felt quite intoxicated after a single drink, but if I went on to drink anything more I felt absolutely nothing. The hangover was enormous (even after just 1), so I concluded it really wasn’t worth the trouble.

I don’t expect this to inspire anyone to begin drinking, but after looking I know there are a lot of people already out there looking for answers on this topic. Really, I am just hoping to inform people so that whatever decision they make is done in a safe, smart way.