[online user]

I am on Cymbalta and Remeron for Major Depression, Recurrent. One of them, perhaps both, say "Avoid Alcohol" as this can damage the liver. Sometimes it's really hard not to have a small glass of wine. How bad for me is this if I do it?

Giving away my wine cellar now, and saying "no" nearly always to drinks of any kind. But not being perfect....

[madisgram]

i'd speak with your pharmasist or pdoc to understand the mixing of these. i was told the alcohol interferes with the benefit of the meds. like one negates the other. i did have a serious reaction once. was semi-comatose-awake but not reasoning. idk. these are the things i'd consider or do. i've been told many reasons but this is from my own experience or knowledge.

[online user]

Thanks! Yes, I am going to ask the Pdoc when I see her this week. I had meant to ask my GP, but forgot. Too many other issues to talk about. Like what to do with the spot on my lung they found after my knee surgery. My cardiologist had sent me for a lung CT because of shortness of breath and my leg swelling...was afraid I'd thrown a clot. No clot, just this spot. Have to wait another 2 months and then they will rescan it and see if it has changed. So, one more thing to worry about. But I have never been a smoker, so that makes a benign growth more likely. But I am the age for cancer, and had a lot of second hand smoke in my younger days...so you worry, you know?

[Christina86]

I just decided to avoid all alcohol after having a drink and having taken my regular antidepressant earlier that day - I honestly thought I was going to die. My heart was racing, my pulse went up, I started sweating... I honestly was scared to death. So after that I just decided to stop drinking, it's not worth the risks. I'm not sure about how much would negate the actual effects of a med by consuming alcohol but alcohol affects your liver, and your body uses your liver to also break down meds, so I'm betting there is some pretty big effects happening in the long term. But that's just me.

[sugahorse1]

I get tipsy a lot quicker since I've been on my meds.
But I still drink

[OneRiffTooMany]

I believe alcohol is a bad substance medicated or not.
Spose it depends on how an individual treats themselves in other areas i.e food diet exercise.
Ive have to get blood tests to check my kidneys ability to process the med im on at the moment, So its been 4 months without a sip. didnt think Id say this but I feel good about declining offers of a beverage.
you do what you got to do I spose.
Cheers

[Elana05]

I've given it up too. Though I never used to drink all that much. I take a high dose of the herb St. John's Wort. In the past year when I have had the ocassional glass of wine or beer I feel rotten an hour later with heart racing and nausea. So I finally just said forget it. It wasn't worth it. They even say there are supposed to be no problems with it with this herb. But it makes me feel weird. Anyway alcohol is a depressant. Don't need to go there... If I go out I get seltzer with lime or tea, hot or iced.

[Perna]

I think it is playing with fire to "question" warnings on medicine. I question why someone would want to do that, gamble with their life and health when they already have a problem and need/are taking the medication anyway.

[online user]

Thanks for all the opinions. I, too, have mostly given it up. But, we were invited over to friends and I was just handed a small glass of wine, from something her boyfriend brought just for us. I nursed that small glass all night long, but still wondered if I should have done that.

Read the fine print on some papers that came from Lilly today (they have a "Touchpoints" program designed to encourage you to stay on their pricey drug). It said that in 3 patients in a clinical trial who ingested a substantial amount of alcohol, there was liver damage. So no alcohol is recommended to be on the safe side. So this is more than just mixing and making you ill or too tipsy...it can be a life-ender, in extreme cases. So, if it is bad in the extreme, probably not the wisest even in small amounts.

[sugahorse1]

I was never aware that alcohol would have a more adverse affect on the liver while on psych meds, than when you are not on psych meds...
But I do know that alcohol, as a depressant, can interfere with the action of ADs and other psych meds

[online user]

With the Cymbalta, only, this interaction I think. The fine print notes that Cymbalta is not likely to make you more tipsy as some other psych meds are, but isn't advised for those with substantial alcohol use, because of 3 cases of liver failure in clinical trials. Those, as I said, were in people who drank substantially. I think each med might have a different reaction.

Too much alcohol we know is bad for the liver--can lead to ciahhrosis (sp?) in alcoholics.

Sigh! Do enjoy a good glass of wine...or, at least, I used to!

[MirageXD]

I'm on antipsychotics. Generally, alcohol worsens the side effects of medication. I used to feel really stiff after consuming alcohol. Currently, I have more serious problems with it. My cognitive deficit gets worse when I drink a bit, and that's bad. So, I've given up drinking too.

[Taonuviel]

I've taken up regularly enjoying a single serving of beer or wine in the evening with dinner. Looking at my 3 meds, none of the current bottles say not to drink alcohol with them, though it seems they may have had those stickers on previous bottles, and one does say that the med may cause drowsiness and dizziness, and that alcohol may intensify this effect. But I've never felt that affect with or without alcohol. And I know my depression hasn't worsened since I began having a drink regularly, which was a few months ago, so I'm not worried about it.
Honestly, depending on the med and your personal tolerance for alcohol/history of substance abuse(any history of substance abuse is a really good reason to NOT DRINK!), I think alcohol, in moderation, is ok. But it can vary by medicine, and is definitely something to ask your doctor about.

http://pubs.niaaa.nih.gov/publications/aa27.htm:
How Alcohol and Drugs Interact
To exert its desired effect, a drug generally must travel through the bloodstream to its site of action, where it produces some change in an organ or tissue. The drug's effects then diminish as it is processed (metabolized) by enzymes and eliminated from the body. Alcohol behaves similarly, traveling through the bloodstream, acting upon the brain to cause intoxication, and finally being metabolized and eliminated, principally by the liver. The extent to which an administered dose of a drug reaches its site of action may be termed its availability. Alcohol can influence the effectiveness of a drug by altering its availability. Typical alcohol-drug interactions include the following (7): First, an acute dose of alcohol (a single drink or several drinks over several hours) may inhibit a drug's metabolism by competing with the drug for the same set of metabolizing enzymes. This interaction prolongs and enhances the drug's availability, potentially increasing the patient's risk of experiencing harmful side effects from the drug. Second, in contrast, chronic (long-term) alcohol ingestion may activate drug-metabolizing enzymes, thus decreasing the drug's availability and diminishing its effects. After these enzymes have been activated, they remain so even in the absence of alcohol, affecting the metabolism of certain drugs for several weeks after cessation of drinking (8). Thus, a recently abstinent chronic drinker may need higher doses of medications than those required by nondrinkers to achieve therapeutic levels of certain drugs. Third, enzymes activated by chronic alcohol consumption transform some drugs into toxic chemicals that can damage the liver or other organs. Fourth, alcohol can magnify the inhibitory effects of sedative and narcotic drugs at their sites of action in the brain. To add to the complexity of these interactions, some drugs affect the metabolism of alcohol, thus altering its potential for intoxication and the adverse effects associated with alcohol consumption (7).

Antidepressants. Alcoholism and depression are frequently associated (14), leading to a high potential for alcohol-antidepressant interactions. Alcohol increases the sedative effect of tricyclic antidepressants such as amitriptyline (Elavil and others), impairing mental skills required for driving (15). Acute alcohol consumption increases the availability of some tricyclics, potentially increasing their sedative effects (16); chronic alcohol consumption appears to increase the availability of some tricyclics and to decrease the availability of others (17,18). The significance of these interactions is unclear. These chronic effects persist in recovering alcoholics (17).
A chemical called tyramine, found in some beers and wine, interacts with some anti-depressants, such as monoamine oxidase inhibitors, to produce a dangerous rise in blood pressure (7). As little as one standard drink may create a risk that this interaction will occur.

Antipsychotic medications. Drugs such as chlorpromazine (Thorazine) are used to diminish psychotic symptoms such as delusions and hallucinations. Acute alcohol consumption increases the sedative effect of these drugs (20), resulting in impaired coordination and potentially fatal breathing difficulties (7). The combination of chronic alcohol ingestion and antipsychotic drugs may result in liver damage (21).
Antiseizure medications.These drugs are prescribed mainly to treat epilepsy. Acute alcohol consumption increases the availability of phenytoin (Dilantin) and the risk of drug-related side effects. Chronic drinking may decrease phenytoin availability, significantly reducing the patient's protection against epileptic seizures, even during a period of abstinence (8,22).

Sedatives and hypnotics ("sleeping pills"). Benzodiazepines such as diazepam (Valium) are generally prescribed to treat anxiety and insomnia. Because of their greater safety margin, they have largely replaced the barbiturates, now used mostly in the emergency treatment of convulsions (2).
Doses of benzodiazepines that are excessively sedating may cause severe drowsiness in the presence of alcohol (35), increasing the risk of household and automotive accidents (15,36). This may be especially true in older people, who demonstrate an increased response to these drugs (5,19). Low doses of flurazepam (Dalmane) interact with low doses of alcohol to impair driving ability, even when alcohol is ingested the morning after taking Dalmane. Since alcoholics often suffer from anxiety and insomnia, and since many of them take morning drinks, this interaction may be dangerous (37).
The benzodiazepine lorazepam (Ativan) is being increasingly used for its antianxiety and sedative effects. The combination of alcohol and lorazepam may result in depressed heart and breathing functions; therefore, lorazepam should not be administered to intoxicated patients (38).
Acute alcohol consumption increases the availability of barbiturates, prolonging their sedative effect. Chronic alcohol consumption decreases barbiturate availability through enzyme activation (2). In addition, acute or chronic alcohol consumption enhances the sedative effect of barbiturates at their site of action in the brain, sometimes leading to coma or fatal respiratory depression (39).

Alcohol-Medication Interactions--A Commentary by
NIAAA Director Enoch Gordis, M.D.
Individuals who drink alcoholic beverages should be aware that simultaneous use of alcohol and medications--both prescribed and over-the-counter--has the potential to cause problems. For example, even very small doses of alcohol probably should not be used with antihistamines and other medications with sedative effects. Individuals who drink larger amounts of alcohol may run into problems when commonly used medications (e.g., acetaminophen) are taken at the same time or even shortly after drinking has stopped. Elderly individuals should be especially careful of these potential problems due to their generally greater reliance on multiple medications and age-related changes in physiology.

[Beholden]

My Pdoc told me I couldn't take Cymbalta anymore because of my KIDNEY disease. Cymbalta is one of the only antideppressants that is cleared by the kidneys, not the liver.

The reason for not having alcohol with the Remeron that you take might be because of the side effects. This is just 2 that would make me not want to drink alcohol with it:

"... you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
...remember that alcohol can add to the drowsiness caused by this medication. (from a website about Remeron.)

At least that is MHO

There are other side effects that can happen as well but when I was asking my pdoc if it was safe for me to take my ambien with a pain medication I think it was, he said it isn't a great idea due to the likelyhood of it making me dizzy and having a fall.

So it isn't always about what it is doing to some of your major organs. Though I'd expect it to not "help" any part of your body either.

Hope you are doing well.