Due to the prevalence of alcohol in American society—86 percent of American adults drink alcohol to some extent—many people feel safe mixing alcohol with just about any substance under the sun. This can mean allergy medication, OTC anti-inflammatories, antidepressants, anti-anxiety pills, and, yes, antipsychotics. Popping a prescribed pill and heading to the bar or a party is something that most people wouldn’t think twice about.
On the surface, this may seem fine, especially when there may not be immediately evident effects. In reality, though, it is not a good idea. Alcohol can interact with all kinds of medications with potentially serious long-term ramifications—and this includes many common antipsychotics. For those who take antipsychotics, understanding how these substances interact, as well as the dangerous side effects of combining the two, is critical to safe and effective use.
The Effects of Alcohol
The effects of alcohol are well known to most people, particularly those who are regular drinkers. Alcohol lowers inhibitions, complicates motor function and memory, and decreases critical thinking skills. People who are drunk regularly say and do things they would not do when sober, injure themselves due to uncoordinated movements, speak with slurred words, and take risks, like driving drunk or having unprotected sex, that wouldn’t seem logical when not inebriated. However, these effects aren’t random; they’re driven by the biological mechanisms of alcohol.
Alcohol is a central nervous system depressant. This means that in excess quantities, alcohol amplifies the performance of the neurotransmitter GABA (gamma-aminobutyric acid). GABA is a major inhibitory amino acid within the brain that can slow or sedate several functions of the central nervous system (CNS). Too much alcohol can slow breathing and heart rate to the point that excessive intake can result in alcohol poisoning or death.
The enjoyable aspects of alcohol, as well as the potential dangers, are obvious to most drinkers, but the biology aspect plays an important role that is often overlooked. How a substance functions within the body directly ties into why blending drugs can be a problem.
What Are Antipsychotics?
The blanket term “antipsychotic” applies to a class of medication used to treat conditions that fall into the category of psychosis. Numerous diagnoses can be addressed with antipsychotic medications, including:
- Bipolar disorder
- Severe anxiety or depression
- Schizoaffective disorder
- Symptoms associated with certain personality disorders
In rare cases, antipsychotics can be used to treat other, non-psychiatric conditions. These include chronic hiccups, symptoms of agitation in dementia patients, and physical problems with balance and nausea.
Most antipsychotic drugs are divided into two classes: typical and atypical. Typical antipsychotics are drugs that were approved around the 1950s and have been prescribed for decades. These drugs are still in use today, though side effects can be challenging for some patients. Atypical antipsychotics are newer medications, many of which were approved in the 1990s. Many of these drugs are better suited for specific conditions rather than for blanket use.
The most common antipsychotics, both typical and atypical, are drugs like:
- Haldol (haloperidol)
- Abilify (aripiprazole)
- Seroquel (quetiapine)
- Loxitane (loxapine)
- Zyprexa (olanzapine)
- Thorazine (chlorpromazine)
The Effects of Antipsychotics
In order to address the mechanisms behind psychosis, antipsychotics must impact the ways in which the brain functions. Generally, this means influencing levels of various neurotransmitters, like dopamine, serotonin, noradrenaline, and acetylcholine.
By rebalancing how and when these chemicals occur within the brain, it’s possible to regulate mood swings, reduce or eliminate hallucinations, prevent manic episodes, ease intrusive thoughts, and eliminate delusions. How each specific drug interacts within the body can vary, which is why many patients require some trial and error to determine an effective medication regimen.
Mixing Antipsychotics and Alcohol
Mixing antipsychotics and alcohol is often a function of coincidence rather than intention. It most commonly occurs when someone taking antipsychotics chooses to drink alcohol. However, some users may find the combined side effects pleasurable. Others may find the appeals of alcohol worth the potential danger of antipsychotics and alcohol together.
Due to the ways in which alcohol and antipsychotics both affect neurotransmitters, alcohol use can minimize the effectiveness of antipsychotics. This means that hallucinations or delusions can return, as well as states of mania. When combined with drunkeness, these effects can be exciting rather than alarming for some users. Unfortunately, this can worsen the symptoms of mental illness—the same illness antipsychotics were prescribed to treat in the first place.
Drinking on Abilify or similar drugs may not seem like a serious issue, but it can be, depending on the severity of a diagnosis. Those with severe bipolar disorder or schizophrenia, for example, may be a danger to themselves or others, so alcohol use could make patients unsafe or otherwise unstable in a way antipsychotics can normally prevent. This could be very dangerous and may result in injury or death.
In addition, some antipsychotics can exacerbate depression of the CNS, meaning that breathing and heart rate will slow faster than under normal circumstances. When this occurs, signs of alcohol poisoning and overdose can arise more rapidly.
Signs of a Problem
Signs of an addiction problem can arise with the use of virtually any substance, including alcohol in combination with antipsychotics. The signs of a problem when using these two drugs may include:
- Making excuses to get drunk or high
- Hiding use from others, including avoiding social obligations and canceling plans to use
- Lack of control and inability to stop using
- Planning all social outings around using substances
- An increasing tolerance, or requiring additional access to substances to trigger a satisfying reaction
- Physical or mental withdrawal effects when use isn’t possible or substances aren’t available
It may be possible to eliminate problematic use by changing behaviors, but often, getting professional help is a key part of overcoming addiction. Those addicted to drinking while on antipsychotics may benefit from professional treatment.
When to Seek Help
In many cases, mixing antipsychotics and alcohol is not intentional and doesn’t relate to getting high. However, for those who take antipsychotic medications and find pleasure in excessive alcohol consumption, the combined benefits can be part of the draw of use. Further, some people who previously used antipsychotics and no longer do may seek out antipsychotics for recreational purposes.
When the combined effects of taking alcohol and antipsychotics together become indicative of a problem, getting help is imperative. Some people think rehabilitation is only for recreational addiction, not substance abuse related to necessary prescription medication, but this isn’t true. Treatment can address substance use disorders of any kind, including the combination of substances.
FHE Health is a comprehensive rehabilitation center offering support for addiction challenges of all kinds. Contact us today to learn more about our programming, including opportunities to address the combined use of antipsychotics and alcohol.