How Antidepressants and SSRIs Affect Alcohol Cravings

22-May-2018

Antidepressants are a type of medication used to treat depression; this can be done by altering levels of certain chemicals in the brain called neurotransmitters. Serotonin, dopamine and noradrenaline are neurotransmitters that have been associated with depression and other mood disorders such as anxiety, phobias and post-traumatic stress disorder.

Drugs prescribed are designed to target these chemicals specifically or work with more than one of these chemicals to alleviate symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs) are a type of medication that helps to reduce the symptoms of depression. Antidepressant SSRI chemicals include Fluoxetine (Prozac) and Citalopram, paroxetine and sertraline. It is thought that serotonin influences mood, emotions and sleep. SSRIs work by inhibiting the reabsorption of serotonin which leaves more of this chemical available in the brain, thus increasing a more positive mood.

While there is evidence for antidepressants consistently alleviate depressive symptoms in patients with co-morbidity alcohol dependence and depression, some groups of patients may show an increase in alcohol consumption. SSRIs are not known to have very serious side effects but there have been recent reports of SSRIs inducing alcohol cravings.

Research has found that antidepressants can intensify the effects of alcohol, or can lead individuals to increase their alcohol consumption and become heavily dependent on alcohol. SSRIs induced alcoholism is likely to be relatively common but reported as being rare. This is due to under diagnosis and treatment due to assumptions of those who are considered depressed having an increased risk of developing an addiction to alcohol as a form of a coping mechanism.

More studies need to be performed in order to discover the link between antidepressants and SSRIs. Alcohol tends to modify serotonin activity throughout the brain in regards to both signalling and neurotransmission. Since antidepressants prevents reuptake of serotonin, it may lead to elevated levels of serotonin, which could cause manic symptoms, risky behaviour, and dangerous mood swings. Most research has been found to support SSRIs reducing alcohol consumption in animals and humans. Several human studies on heavy drinkers found SSRIs to reduce overall alcohol consumption by approximately 15 to 20 percent (Naranjo et al. 1994).

As well as in one study, of 18 heavy drinkers the SSRI Citalopram reduced both drinking and self-reported craving for alcohol (Kranzler et al. 1995). Although, these studies may support the theory that SSRIs reduce alcohol consumption their samples only include those who are already heavily dependent on alcohol. In addition, these reports are only correlation and therefore cannot imply causation therefore SSRIs may not be the sole reason for decreasing alcohol consumption.

For example, those who are heavy drinkers may be depressed (an issue of co-morbidity). Therefore, when these individuals take SSRIs they no longer need to consume high levels of alcohol as their symptoms of depression are being treated.

Recent reports have suggested that an increase of alcohol consumption is found in those who are not classified as dependent. This means that those who were not alcohol dependent become dependent due to changes in their brain chemicals. Some research has linked SSRI (such as Paxil) to increased alcohol cravings and abuse.

This risk might be higher in people who carry certain genes that already make them more susceptible to alcohol abuse. For example, the 5-HT3 serotonin receptor is rapidly enhanced by ethanol (chemical found in alcohol) that releases dopamine in the reward system (Enoch, Gorodetsky, Hodgkinson, Roy & Goldman, 2011). This serotonin transporter gene has been linked to excessive drinking, alcohol dependence and impulsiveness.

Suggestively, the reward sensations felt when consuming alcohol while on antidepressant medication is perhaps a cause of alcohol dependency. Further evidence, comes from an increase of women becoming alcohol dependent associated with an increase of women being prescribed on antidepressants. With one in three women now taking antidepressants, women suffer more adverse reactions to antidepressants which could illustrate a reason why 4% of women are now alcohol dependent.

From now, it is important to avoid alcohol while on antidepressants. Although, medications do not specifically instruct users to avoid alcohol completely it is important to be very careful when mixing alcohol and medications. Drugs are only tested on only thousands of patients but are then given to millions of people and therefore not all serious side effects may be noted.