Posted by Paul on December 8, 1998, at 13:35:15
In reply to Re: Celexa and Alcohol, posted by Toby on December 4, 1998, at 15:47:08
> Just because Paul didn't notice any problems while taking Prozac/Zoloft and alcohol, doesn't mean there weren't any problems. I daresay he didn't notice any change in his serotonin levels either until he had full blown depression. Alterations at the cellular level may seem small when compared to overt interactions that cause vomiting, weakness, dizziness, blindness or some other symptom that tells you there is an interaction occurring, but small changes can lead to problems in the long run that, by the time they are recognized, may seem to have no relationship to the true cause. I sometimes wonder if tobacco, alcohol, other illict drugs, or even diet may not be related to "antidepressant poopout" and we just don't know it because we can't easily measure the "interactions" between the antidepressant and these substances.
> I am not condemning alcohol, just presenting another way of looking at the question. Also, it's not "mindless" in the way the warnings are given. The labels are premade in vast quantities because alcohol does affect so many medications (mostly because it is metabolized in the liver and most medications are, too).Well put Toby, you have given me something to think about. I knew there were holes in my argument.
However, in a broader discussion of "mindfulness" as regards some (of course not all) doctors' and pharmacists' advice about pharmaceuticals in general, I think there is much mindlessness. Much of what I have learned comes from my reading, driven by curiosity and a desire to learn. No doubt you are likely correct about alcohol and antidepressant combinations, and the subtle nature of interaction at the molecular level. However, I would venture to guess that 3 out of 5 pharmacists, if asked, could not give such a good answer as yours. Most would likely list the possibility of the most general reactions to most medicines: nausea, headache, etc. This lack of specificity and thoughtfulness with regards to giving advice about drugs with such precise and specific mechanisms is the "mindlessness" to which I refer. And as far as labels are concerned, I do think "do not drink alcohol," while not mindless advice in and of itself and may be with good reason, is mindless when slapped on just about everything prescribed, with no accompanying explanation. It is also an absolutist piece of advice that doesn't apply to all medications in all circumstances, and though it may apply to many, it should be put on a bottle for a specific reason. Most pharmacists or pharmacists' assistants just rattle off the standard precautions they have been taught. I long for the day when the pharmacist can give me an answer such as yours, and I can be humbled as a layperson in front of an expert.
poster:Paul
thread:1460
URL: http://www.dr-bob.org/babble/19981201/msgs/1515.html