Dangerous cocktails: Trittico and alcohol, what happens if you combine pills and alcohol

Home>Articles>Dangerous consequences of simultaneous use of antidepressants and alcohol

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• Functioning of antidepressant drugs
• Alcohol while taking antidepressants
• SSRIs-antidepressants and alcohol
• Tricyclic antidepressants
• MAO inhibitors
• Alcohol with herbal antidepressants
• Antidepressants and alcohol: consequences of joint use
• Antidepressants and alcohol after completing a course of medication

Antidepressants and alcoholic drinks are incompatible things. If there is alcohol in the blood, the risk of side effects of antidepressants increases, which especially concerns the central nervous system. Let's look at why this happens.

Side effects of Trazodone

From the nervous system and sensory organs:

fatigue, weakness, headache, dizziness, insomnia, drowsiness, agitation, psychosis, hypomania, hallucinations, tremor, muscle twitching, grand mal seizures,
aphasia
, ataxia, akathisia, dyskinesia, paresthesia, confusion, syncope, blurred vision, diplopia.

From the cardiovascular system and blood (hematopoiesis, hemostasis):

arterial hypotension, incl. orthostatic; atrial fibrillation, arrhythmias (including tachy- and bradycardia, ectopic ventricular rhythms), congestive heart failure, leukocytosis or leukopenia, neutropenia (usually minor), hemolytic anemia, methemoglobinemia.

From the gastrointestinal tract:

increased appetite, dryness and unpleasant taste in the mouth, hypersalivation, caries, diseases of the periodontal tissues, oral candidiasis, nausea, vomiting, flatulence, diarrhea, constipation, cholestasis, increased levels of bilirubin and amylase in the blood plasma, jaundice.

From the genitourinary system:

urinary retention, increased frequency of urination, hematuria, premature menstruation, hirsutism, increased libido, priapism, impotence, retrograde ejaculation.

Allergic reactions:

skin rash, urticaria.

Other:

myalgia, chest pain, alopecia, psoriasis, edema.

Consequences of co-administration

Clinically, simultaneous use of trittico with alcohol can manifest itself as mental disorders: hallucinations, delusions, manic state. In addition, pathological drowsiness and impaired consciousness may occur, leading to coma. There is also a high probability of developing dysfunction of the autonomic nervous system, which manifests itself in a decrease in blood pressure, a decrease in heart rate, and depression of the respiratory center. In severe cases, death is possible.

In order for trittico and alcohol breakdown products to be eliminated from the body, they must first be metabolized in the liver. In this organ they bind to the same structures, thus preventing each other from being eliminated. Thus, both the medication and the alcohol will circulate in the blood unchanged for a long time, causing a toxic effect on the liver.

Interaction

Unlike typical antidepressants, it does not reduce the depressive effects of reserpine, weakens the central effect of amphetamine and the peripheral effect of norepinephrine. Potentiates the effect of CNS depressants (including barbiturates, tricyclic antidepressants, antihistamines, clonidine, alcohol), anticholinergics and muscle relaxants. When taken simultaneously with antihypertensive drugs, the risk of orthostatic hypotension increases. Weakens the effect of psychostimulants. Increases plasma concentrations of digoxin and phenytoin. Should not be used simultaneously with MAO inhibitors.

Interaction with ritonavir

The effect of short-term administration of ritonavir (200 mg twice daily for 2 days) on the pharmacokinetics of a single dose of trazodone (50 mg) was studied in 10 healthy subjects. It was shown that Cmax of trazodone increased by 34%, AUC by 2.4 times, T1/2 by 2.2 times, clearance decreased by 52%. Adverse effects including nausea, hypotension, and syncope have been observed when ritonavir and trazodone were used together. If ritonavir and trazodone are used concomitantly, a dose reduction of trazodone may be necessary.

Interaction with CYP3A4 isoenzyme inhibitors

In vitro studies of the metabolism of trazodone indicate the possibility of its interaction with inhibitors of the cytochrome P450 isoenzyme CYP3A4, such as ketoconazole, ritonavir, indinavir sulfate and fluoxetine. Inhibitors of CYP3A4 may lead to significant increases in plasma concentrations of trazodone, thereby increasing the likelihood of adverse events. Therefore, when used in combination with potent CYP3A4 inhibitors, the dose of trazodone should be reduced.

Interaction with carbamazepine

After co-administration of the CYP3A4 inducer carbamazepine (at a dose of 400 mg / day) with trazodone (100-300 mg daily), carbamazepine reduced the plasma concentrations of trazodone and m-chlorophenylpiperazine (the active metabolite) by 60 and 76%, respectively. Patients receiving trazodone and carbamazepine concomitantly should be closely monitored.

Interaction with warfarin

There are reports of changes (increase or decrease) in PT with simultaneous use of warfarin and trazodone.

What is the basis for the functioning of antidepressant drugs?

Basically, antidepressants are taken with the aim of increasing in the body the degree of production of hormones responsible for a favorable emotional background, normal mood, and an active mood.

After completing a course of taking such drugs, the patient begins to become interested in life, events and the people around him. The thoughts that his life is aimless and meaningless disappear.

The effect of taking such medications can be felt 14 days after starting to take the drugs, not earlier. The shortest duration of treatment is 3-4 months.

If the patient also has an alcohol addiction, then for the sake of his health and mental state he must give up alcohol for the entire duration of the course. Otherwise, dangerous side effects may occur, the effects of which will be enhanced by drinking alcohol.

Precautions for the substance Trazodone

During treatment, a general blood test should be performed regularly (for timely detection of leuko- and neutropenia); ECG monitoring is desirable in patients with cardiovascular diseases. Careful monitoring of patients with suicidal tendencies is required, especially in the first weeks of treatment. Treatment is immediately stopped with the development of priapism, severe neutro- and leukopenia; in other cases, drug withdrawal should be carried out gradually. During treatment you should avoid drinking alcohol.

Use with caution during work for vehicle drivers and people whose activities involve increased concentration.

Tricyclic antidepressants

The structure of these drugs is similar: 3 connected ring-shaped molecules. This list includes drugs that contain the following active ingredients:

• Amitriptyline;
• Clomipramine;
• Imipramine;
• Tianeptine;
• Pipofezin.

Such drugs have increased toxicity, so drinking alcohol while taking them is prohibited. Tricyclics have many serious side effects, and the presence of alcohol in the blood increases the risk of their occurrence or enhances their effects.

Tricyclic drugs are not compatible with alcohol, other medications, or certain foods.

Possible adverse reactions include the following.

1. Problems with the functioning of the digestive tract (constipation, urinary retention). State of drowsiness, rapid heartbeat. Confusion of thoughts and consciousness may be recorded.
2. A person gains excess weight and his blood pressure drops.
3. Loss of appetite, feeling of nausea.
4. Ejaculation and erection become worse.
5. Convulsive attacks occur.
6. Psychopathological symptoms worsen.
7. Hypotension is observed.

Stages of the fight against drunkenness without coding

Therapy for chronic alcoholism when the patient refuses to undergo coding includes the following steps:

1. Detoxification.
2. Overcoming withdrawal symptoms.
3. Improving the functioning of internal organs.
4. Psychotherapy sessions.
5. Rehabilitation.

Let's look at each in more detail.

Detoxification

Aimed at accelerating cleansing the body of alcohol and harmful metabolites formed during its breakdown and elimination. Can be given in the following ways:

• Hardware blood purification using plasmapheresis, hemodialysis. Such procedures are indicated for severe intoxication resulting from a multi-day binge. Involves the use of special medical equipment. Implemented only in a hospital setting under constant medical supervision.
• Infusion therapy. It involves installing cleansing droppers. It is in high demand among alcohol addicts due to its safety, simplicity and accessibility. The infusion composition can be administered both in the treatment room of a drug clinic and at home. The patient receives intravenous drips of saline solution, glucose, various sorbent mixtures, potassium-magnesium complex, etc.
• Gastric lavage. Applicable only at the initial stage of alcohol intoxication. It prevents the absorption of ethyl alcohol, thereby significantly facilitating the patient’s well-being.

Overcoming withdrawal symptoms and restoring the functioning of internal organs

Withdrawal syndrome in alcohol addicts occurs in response to giving up drinking. If a person drinks for several days and then suddenly stops, he becomes very ill.

To treat withdrawal symptoms, narcologists administer IVs and perform physical procedures. In parallel, sedatives, hypnotics, hepatoprotectors, nootropics, vitamins and minerals are prescribed.

Psychotherapy sessions

After drug correction, the patient’s physical condition stabilizes. Then the psychotherapist at the drug center begins working with him. The specialist helps you understand the dangers of alcoholism and convinces you of the need for further treatment. The main emphasis is on:

• strengthening motivation for sobriety;
• mobilization of forces to further combat drunkenness;
• overcoming stress associated with the need to completely abstain from “hot” drinks;
• developing the ability to resist the desire to get drunk;
• setting new life goals.

Psychotherapy sessions can take place in individual or group format. How often they will be carried out depends on the characteristics of the clinical situation.

Rehabilitation

The rehabilitation period includes adaptation to life without alcohol. It is very difficult for people who drink to change their habits. Since their favorite stimulant - vodka - is banned, they begin to get nervous more often and have less control over their emotions.

Psychological support is especially valuable at this time. It is important that the recovering person is not left alone with his misfortune. He needs to look for reasons to be happy and constantly block thoughts about alcohol.

Trittico and beer

Trittico and beer are incompatible. The result is formed by interacting with brain recipes, but ethanol inhibits this effect. Depression and psychosis worsen. The sedative and muscle relaxant effects are eliminated.

During therapy with antidepressants, it is prohibited to drink alcoholic beverages. Beer causes ethanol to spread into the central nervous system and damage neurons. This causes deterioration, a relapse of the underlying disease.

The patient's psycho-emotional state is unstable, he becomes dangerous to people.

There is an increased load on the cardiovascular and nervous system. Side effects of the medication occur.

Main groups of antidepressants

Depressive conditions and other mental disorders can be very different in their cause, manifestations, severity and other characteristics. Depending on this, only a doctor can objectively assess the possible risks and effectiveness of a particular drug and prescribe treatment and the required dosage.

The main groups of antidepressants include:

• Tricyclic antidepressants: Tryptisol, Azafen, Coaxil, Amitriptyline.
• SSRIs: Zoloft, Prozac, Cipralex.
• MAO inhibitors: Aurorix, Pyrazidol.

Effect of drugs

Antidepressants have a stimulating psycho-energizing effect) on the central nervous system, resulting in:

• increasing initiative,
• activation of thinking, normal daily activities,
• reduction of physical fatigue;
• reducing anxiety;
• normalization of sleep.

Olanzapine and alcohol alter brain activity

Booze and drugs act by changing neurotransmitter systems. The drug inhibits the functioning of serotonin and dopamine receptors. Because of this, arousal in specific brain structures decreases. A stable sedative and antipsychotic effect develops.

Ethanol, when taken in small doses, stimulates brain activity. This is explained by its ability to excite neurons responsible for the production of dopamine. Consequently, at the very beginning of intoxication, a person’s mental activity increases.

If you take alcohol and an Olanzapine tablet at the same time, the latter will block dopamine receptors, and the former will try to activate them. This effect contributes to the occurrence of acute atypical poisoning without a feeling of joy and relaxation.

If the patient continues to drink, the degree of alcohol intoxication will increase. Then sedation will begin to dominate. The depressive properties of the medication will become more noticeable. The level of dopamine will decrease, and the content of gamma-aminobutyric acid (which is an inhibitory neurotransmitter) will increase. This means that the sedative effect of alcohol will enhance the sedative properties of the antipsychotic.

Thus, drinking during a course of Olanzapine is fraught with excessive sedation. This condition is characterized by:

• decreased muscle tone;
• weakness;
• dizziness;
• loss of consciousness;
• breathing disorders (up to its depression due to blocking of the respiratory center of the brain);
• development of a coma;
• heart rhythm failure;
• heart failure.

Is it worth risking your health because of a banal desire to drink something strong? Of course not. During treatment with Olanzapine, the patient must strictly observe the “law of sobriety”. When his mental condition improves, the doctor will stop the antipsychotic. After achieving stable remission, it will be possible to again raise the question of the possibility of periodic drinking of alcohol. But not before.

Literature:

1. Lelechiv S.V., Velichko I.M., Neurochemical aspects of alcohol intoxication. Journal of Grodno State Medical University. Volume 15 (4), 2021
2. Rumyantsev A. A. Olanzapine in the prevention and treatment of nausea and vomiting in patients receiving highly emetogenic therapy. Dissertation of a candidate of medical sciences. 01/14/12. Place of protection: National Medical Research Center of Oncology named after N.N. Blokhina. - Moscow, 2021. - 111 p.
3. Volkov V.P. Cardiotoxicity of antipsychotic drugs. — Tver: Triad, 2021. — 620 p.
4. Bochner F. Psychotropic drugs: a reference book for a practicing physician. - M.: Litterra, 2006. - 292 p.

What are antidepressants?

Antidepressants are medications prescribed to relieve depression and eliminate its symptoms. This group of medications regulates the level of neurotransmitters in the brain, the functioning of which is disrupted during depression. These include:

• serotonin,
• dopamine,
• norepinephrine
• norepinephrine.

When used correctly, sedatives are extremely effective in treating many mental and neurological conditions. They help a person with depression return to normal life, get rid of increased anxiety and regain peace of mind.

Antidepressants (for example, Cymbalta, Asypi, Cipramil) can be prescribed for various anxiety conditions, neuroses, eating disorders, self-esteem disorders, chronic pain, etc. The effect of antidepressant therapy occurs on average after 1-2 weeks of taking the drug, and the duration of the course of treatment can vary from several months to 2-3 years, depending on the patient’s condition and the severity of the disease.

Use for hangover syndrome

A hangover is a condition in which the body suffers from severe poisoning by methanol breakdown products. In most cases, the patient notes signs of acute dehydration due to water-electrolyte imbalance, nausea with vomiting, diarrhea, migraine, dizziness, and increased body temperature.

It is best not to take pills in such a situation, so as not to provoke additional side effects.

To eliminate withdrawal symptoms, brine and special preparations are used that remove acetaldehyde from the blood. Only after complete cleansing can you start taking the medicine.

Help with detoxification in drug treatment

If such a situation occurs and a person experiences negative symptoms due to taking a sedative with alcohol, it is necessary to urgently consult a neurologist for a detoxification procedure.

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Specialists can detoxify the body using a drip both in the clinic and at home. In severe cases, a resuscitation team arrives on call, and hardware techniques are used for detoxification.

Treatment prices:

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As a result, the load on internal organs sharply increases, which can lead to:

• A sharp jump in blood pressure,
• Tachycardia,
• Shortness of breath.

In severe cases, a hypertensive crisis may occur.