Does alcohol stop antidepressants from working?

[michaelmyers24]

Hi, i have been on the SSRI setraline for about 4 months now. It has made me feel very good, releiving my anxiety and depression and making me feel like myself again. However, i binge drinked on new years eve and it feels as if the medication has stopped working and i fell into a deep horrible depression. Also i'm getting weird shock sensations throughout my body. I haven't missed a dose and i'm currently on 50mg. Will my medication ever work again? i'm pretty confused as to why this is happening and why its taking so long for my medication to work again even tho ive been taking it everday

[Paxiled]

As you probably know, alcohol is contraindicated both when you're an anxiety sufferer and when you take an antidepressant.  Since it's been awhile since the incident and doesn't appear to be going away, I'd go and talk to your psychiatrist and see what he or she thinks.  But here's what may have happened -- to a lot of people who suffer with anxiety or depression, taking recreational drugs can turn us inward and make us feel disoriented, just the things mental illness does to us.  That can trigger the problem that still lies inside you, because there are no drugs yet discovered that cure mental illness, they just tamp down the symptoms.  The only cure we know now are therapy, which sometimes works and when it does the problem goes away, and lifestyle changes that can also sometimes make it go away.  Sometimes it spontaneously goes away about the way it came in the first place.  But drugs can also poop out, and sometimes this happens when something particularly bothersome to us happens -- it happened to me once when I suffered a painful breakup and my antidepressant just stopped working completely.  Stuff happens.  So talk it out with your doc and see if you can't find a solution.

[michaelmyers24]

hey paxil, thank you for your answer. I am a bit confused because It just wouldn't make sense for a serotonegeric drug to stop working due to increased stress or drinking. From my understanding they strengthen the communication between certain 5HT receptors within in the brain, but they must do more than that if they interact so strangely with alcohol or poop out due to stress. I guess the alcohol would interfere with the mechanism of the drug "SSRI" but the effects of that should only last a day or two and not take so long to begin working properly.  Also, i find it strange that we don't have a more effective drug or treatment for anxiety and depression, the idea of antidepressants is brilliant but i wonder why they usually don't work for people.

[Paxiled]

Well, the truth is, medicine can't cure most of the things that ail us.  Much of what we know is marketing, not fact, as in our system we've allowed medicine to be part of our moneymaking and greed rather than setting health apart as too important for those things.  Drug companies are there to sell drugs, not to cure you of anything.  Many things are treated with drugs when they actually make things worse in the long term and long known natural medicine is better, such as for most digestive problems.  So there's that.  You also don't understand how ssris work -- they work by using the serotonin our bodies naturally produce from eating foods that contain tryptophan and B6 and vitamin C and direct it just a couple of receptors instead of the many receptors that exist in the brain (most serotonin isn't in the brain and does other things).  They also, and this is most important, block the enzyme the body uses to break down and evacuate used serotonin so the serotonin can wash around longer in the targeted receptors.  There is no evidence serotonin is at all involved in causing mental illness, but playing with it can make us feel better until it doesn't. anymore.  Since it's not a cure, you still have the problem, it just doesn't bother you as much anymore, but when anything including a stressful event overwhelms the drug, well, the underlying condition is still there and it just comes back again.  Some people are luckier than others with these meds, as our bodies are very individual things and brains are very complex things we have very little understanding of so far.  Believe it or not, we still have no scientific explanation for mental illness.  What alcohol does actually is intensify the effect of antidepressants, that's why it's contraindicated, but alcohol also affects things like balance, orientation, and focus.  If you focus too much on something stressful the drug may not be powerful enough to overcome it, but with the passage of time it might start working again.  Basically, something causes us to talk ourselves into these illnesses in a way others don't, and we can also talk ourselves into a state that the medication can't handle and it stops working.  With all medication and all treatment for everything, there's a lot of placebo involved -- these drugs don't do all that great in clinical trials -- so when they work, the longer we take them the better they tend to work because we become convinced we're doing better and that thinking makes us better.  If we can do that in therapy or just by ourselves we don't need the drugs at all.  It is what it is.    

[Paxiled]

I mean, really, think about it, because it emphasizes the importance of prevention.  We can't cure cancer, but we can often keep it at bay.  We can't cure heart disease, but we can often keep it at bay.  But we can often prevent these things from happening until we're quite old by living a healthy lifestyle.  Some day we'll know a lot more, and people are working really hard out there to get there, and we know a whole lot more today than we did some years ago.  We are moving in a positive direction.  In many ways we're guinea pigs for this stuff, so consider yourself part of the process of figuring this out.  

[michaelmyers24]

makes sense. Sorry, i thought i had a idea of how SSRIs work. I'm pretty sure i read somewhere that chronic stress dis regulates the HPA axis and the 5HT system is heavly integrated in the HPA axis. My anxiety was caused by chronic stress and eventually i entered a state of mind that i could never get out of. It makes sense as to why a SSRI would help me because apparently they also help regulate the HPA axis. Thats what i think anyways, i don't think whats happening to me is placebo, its hard to describe. It's almost like i feel like myself before all of the anxiety since taking the medication. At first the medication made me feel more anxious and i had this strange excruciating depressed feeling usually at night that literally felt painful. It would last usually around an hour.

[michaelmyers24]

Ive taken multivitamins before and they did make me feel better, but not near the drastic change that SSRIs do. I also eat pretty healthy, always did but that didn't seem to do anything and i exercised but none of that would get rid of this awful feeling of the physical and mental anxiety i felt. Another weird thing that happened when i started a SSRI, is that my sense of touch, smell and taste are drastically better. When i touch things or look at things i feel a more of emotional connection to them. I know that sounds weird but bare with me here, you seem to know quite a bit about this stuff. So i would like to hear you're take on my senses being altered. Also it feels like my memories and emotions feel connected to the past "before the anxiety" like ive been in a coma for 5 years and finally woke up. And my sense of identity feels more grounded. Like i feel comfortable in my own body and don't have this awful short term memory and disorientation. So i think it's alot more than a placebo and that the drug is really making physical changes within my brain. And when i drink alcohol all the positive effects of the AD disappear for a week or two. Sorry if this is a bit much, but i really want to discuss this.

[Paxiled]

No, I didn't meant to imply you had a placebo effect, only that a placebo effect is a part of anything that helps us in the sense that feeling better feeds off itself.  And it wasn't stress that caused your anxiety, it was your way of thinking about the stress and the fact that whatever caused the stress was stressful to you that caused it.  What caused that we don't know scientifically, though it's thought with anxiety to be connected to part of the primitive brain called the amygdyla.  Multivitamins are prophylactic, they shouldn't have any significant effect on anyone -- if they do that person needs to see a doctor pronto.  The fact is, however it got there, you have a disease.  You can take ten people and throw them into the same extremely stressful situation and get ten different reactions.  It's how people are -- we're programmed differently because our brains are so complex and because life is so complex.  Most people just don't thing about it all that much and some of us fixate on it.  Think of those in the military in a war zone -- most of them do not get PTSD and those who do are mostly found to have been prone to anxiety beforehand.  One of the most successful forms of therapy out there, CBT, doesn't care at all how we got this way, it just tries to teach us ways to not be this way.  And despite being the best therapy out there supposedly, in double blind studies it works about 30% of the time, the same as any particular antidepressant.  Fortunately, there are a lot of different meds and a lot of different therapists out there so we can maximize our chances.  I'm 64 and never got better and medication killed me, and brother, I don't want anyone else to have to face this fate.  Get to work, and when something works, don't overthink it, just rejoice in it.  And make sure you understand it so you diminish the chances of it stopping working.  

[Paxiled]

Oh, and I wish I had a reaction like you did to anything -- no med I've been on did more than help me a little.  You had a great reaction.  But what happened isn't so much a scientific thing, it's just that when the stress eased, you didn't have so much getting in the way of what you saw and how you saw it -- thus the feeling of clarity.  

[michaelmyers24]

Did you have a bad experience with medication? if so, what exactly happened? i forgot to mention that i took setraline a few years ago and it had the opposite effect on me, it made me feel lifeless, numb and very apathetic. After 9 months i had to get off the drug because i couldn't stand that feeling anymore, it feels like i lost myself, then my anxiety comes back 7 months later and now i had the apathetic state of mind combined with the anxiety so i was worse off than i have ever been, thats when i decided id rather just be apathetic with no anxiety and went back on setraline, only to discover that it feels as if its reversing the effects of the last setraline and making me become myself again. It's weird that i would have such different reactions to the same drug, i really wonder why that is.

[Paxiled]

Your brain has changed, your body has changed.  Sometimes it works such that a drug that was great never works again once it's been stopped.  As for my experience with meds, well, that's not your worry.

[michaelmyers24]

Does drinking alcohol once on the medication count as stopping it? because its been 2 weeks and it still doesn't feel like my medication has kicked in

[Paxiled]

No.