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From PsychCentral:

Most psychiatric drugs bear some version of the warning: “Do not drink alcoholic beverages when taking this medication.”

In reality, though, many people taking psych meds drink anyway. They have various reasons: not wanting to curtail their fun, not putting much stock in the warnings, or simply thinking it’s easier to take a proffered drink than explain why they’re turning it down.

Doctors oftentimes don’t bother to talk to patients about potential dangers. Or they tell patients not to drink, but don’t explain why. To make matters worse, because of a lack of studies on the subject, patients inclined to do their own research will have a hard time just how risky it is to drink while taking various kinds of psychiatric medications (I’ve written elsewhere about this troubling lack of evidence).

A widely publicized study that came out last month in the journalNeurology underscores the problem. The findings, which pooled data from 16 studies, showed that people taking SSRI antidepressants like Zoloft or Celexa were 40 percent more likely to suffer a type of stroke caused by bleeding in the brain and 50 percent more likely to suffer any bleeding in the skull.

The overall risks remained tiny (this kind of rare stroke occurs in just 26 out of every 100,000 people in a given year, and taking SSRIs could be expected to increase the likelihood by about 1 person out of 10,000).

But in the journal article itself and in multiple news articles, the study’s authors cautioned that people who drink heavily might want to talk to their doctors about switching to a different antidepressant. That’s because numerous studies have shown that drinking heavily also increases the risk of this kind of stroke.

As a journalist, I’m skeptical of exaggerating dangers – especially since this study didn’t even look at at alcohol use directly, and because the risk of suffering brain hemorrhages is so low overall.

But as someone who has taken SSRIs for many years and done my fair share of college and post-college heavy drinking, I have to confess to being slightly unsettled by these warnings.

I also didn’t find it particularly reassuring that the lead authorsuggested that heavy drinkers might want to switch to a different kind of antidepressant, such as Wellbutrin or an older tricyclic drug like Pamelor or Elavil. Both Wellbutrin and alcohol increase the likelihood of seizure, which makes combining them extra-risky (something I only learned after years of doing just that). And tricyclics carry their own risks when combined with alcohol.

The obvious answer, you might say, is simply to be safe, not sorry. In the absence of studies examining the relationship between alcohol, particular psychiatric medications and specific negative health outcomes,  it’s probably wiser to abstain from drinking if the drug you’re taking warns against it.

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