Psycho-Babble Medication Thread 7682

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT

Posted by Franca on June 22, 1999, at 22:43:16

I am one of 3 people who has used Xanax, Zoloft and Prozac. In all these times I noticed some horrible side-effects when drinking amongst all of us. Blathering, incl personal history, I would not usually tell, show none of my usual restraint on yelling at people, phoning and on some sexual incidents. My usual benchmarks and controls weren't there.

I would appreciate some info on this and am also disappointed that there are no warnings about.

Yes, I know we are not supposed to drink on these things, but if we knew the risks things may have been different. I also did not know drink would increase the effect of the anti-depressant ??

I have also read an article on up and coming legal cases in the states where people are suing the company that makes Prozac for cases where people believe murders and deaths would not have happened. eg. The lead singer of Del Shannon shooting himself whilst on Prozac. I found these drugs make you become dissociated and can make you feel more messed up in some ways than before.

I am now very concerned of these side-effects, off these pills and want to know what has been found and what will be done to educate people of these possibilities.

 

Re: BEWARE Bob could you please comment too ?

Posted by Franca on June 22, 1999, at 23:00:30

In reply to BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by Franca on June 22, 1999, at 22:43:16

just asking for Bob's input !! Thanks

 

Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT

Posted by saintjames on June 23, 1999, at 0:09:31

In reply to BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by Franca on June 22, 1999, at 22:43:16

If you are drinking and taking Xanax all of the thing you discribe are common predictable effects...that is why the Rx puts the little stickers on saying do not take w/ "drink". All my AD bottles have a warning about "drink" and taking meds. IT IS COMMON SENSE !

james

 

Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT

Posted by Franca on June 23, 1999, at 1:43:50

In reply to Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by saintjames on June 23, 1999, at 0:09:31

saintjames, why common predictable effects ? This does not help me or others at all. The things done are out of pattern with our normal behaviour, even previous when drunk beh. Del Shannon's wife things he would not have killed himself, there are people who attribute murders to Prozac. I want more substance, not "common sense" retorts.

My GP has also stated that although anti-depressants are getting better at narrowing down the range of brain chemicals that anti-depressants effect, they still effect more brain chemicals than necessary ?? What does this mean, or does anyone really know ?

 

Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT

Posted by Caz on June 23, 1999, at 7:26:20

In reply to Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by Franca on June 23, 1999, at 1:43:50

The reason xanax and alcohol are not a good mix is that they potentiate each other - that is they will increase the effects of each other on your physical and mental behaviour. Alcohol is well known for its disinhibiting effect and I know from personal experience that using xanax in conjunction with alcohol can cause unpredictable behaviour. Usually when I drink I know when I've had enough, I know how many drinks to keep tab of and when to stop. Adding Xanax to the mix I drank my usual amount and felt fine...then my usual self regulation failed and I kept on going until I ended up in a very dangerous situation with a stranger that offered me a ride.

Usually warnings about use of benzodiazepams and alcohol are about the risk in combining two CNS (central nervous system) depressants which can lead to drowsiness and even coma or death.
Not about the type of behaviour changes you describe, however, the warnings are there on the bottle - specific or not, avoid alcohol :)

As for the effect of anti-depressants and alcohol (remember Xanax and Prozac are completely different drugs) my understanding from my GP is that alcohol should be avoided due to the counter-active depressant effect of alcohol which could make your treatment less effective. I haven't read anything about alcohol increasing effects of anti-depressants but would be interested to read anything available.

As for the reports of people commiting suicide or other acts of violence while on Prozac, there is a well known campaign by a certain religious group against this and other drugs, I can dig up a URL to their page if you like. Maybe you have already been there and found this information. My purely personal opinion is that the drug is probably less likely to blame than a failure to monitor and provide an appropriate treatment if that particular drug was not providing relief from the original symptoms.

You are right to ask questions. You are a consumer and your doctor should always be willing to discuss side effects and options with you. My own doc rolls his eyes and laughs when I walk in his office with my latest research and printouts of stuff I found on the web but he knows better than to hustle me out the door before we get through my agenda for the appointment :)

Caz

> saintjames, why common predictable effects ? This does not help me or others at all. The things done are out of pattern with our normal behaviour, even previous when drunk beh. Del Shannon's wife things he would not have killed himself, there are people who attribute murders to Prozac. I want more substance, not "common sense" retorts.
>
> My GP has also stated that although anti-depressants are getting better at narrowing down the range of brain chemicals that anti-depressants effect, they still effect more brain chemicals than necessary ?? What does this mean, or does anyone really know ?

 

Re: BEWARE/COMMENT: personal experience

Posted by Sean on June 23, 1999, at 12:03:38

In reply to BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by Franca on June 22, 1999, at 22:43:16

> I am one of 3 people who has used Xanax, Zoloft and Prozac. In all these times I noticed some horrible side-effects when drinking amongst all of us. Blathering, incl personal history, I would not usually tell, show none of my usual restraint on yelling at people, phoning and on some sexual incidents. My usual benchmarks and controls weren't there.
>
> I would appreciate some info on this and am also disappointed that there are no warnings about.
>
> Yes, I know we are not supposed to drink on these things, but if we knew the risks things may have been different. I also did not know drink would increase the effect of the anti-depressant ??
>
> I have also read an article on up and coming legal cases in the states where people are suing the company that makes Prozac for cases where people believe murders and deaths would not have happened. eg. The lead singer of Del Shannon shooting himself whilst on Prozac. I found these drugs make you become dissociated and can make you feel more messed up in some ways than before.
>
> I am now very concerned of these side-effects, off these pills and want to know what has been found and what will be done to educate people of these possibilities.

While on Zoloft, I had some very similar experiences.
Basically, I became a party animal and would walk
up to just about anybody and start yaking. I
began smoking cigarettes, pot, drinking wine,
etc... and basically succumbing to my lowest
behavioral denominator.

For me, Zo had the twin effect of (a) reducing
my ability to say NO and (b) making it way more
enjoyable to say YES. Now, if only it didn't
destroy my sexual response; I mean I could have
really made up for all that lost time as a
moody wallflower...

Alas, drug induced hypomania is a non-sustainable
lifestyle. It is however, a real kick when you've
spent such a large portion of your life not being
very social.

Yet I think the world does need moody wallflowers,
people who are prone to melancholy and not what
our current society would call "happy". But it
does suck to be suicidal. I just could not find
the in-between with Zo...

As for the murder stuff, I had one discussion
with another person on SSRI's and we agreed that
these drugs would not necessarily make you kill
more easily, but they might certainly make you
care less about the moral consequences. I'm
glad you are talking about this stuff. It is
very interesting to me.

Sean.

 

Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT

Posted by saintjames on June 23, 1999, at 12:21:29

In reply to Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by Franca on June 23, 1999, at 1:43:50

> saintjames, why common predictable effects ?

Xanax + beer = fool

 

drug mixing; "Prozac causes suicide" rumor

Posted by Elizabeth on June 23, 1999, at 23:44:37

In reply to Re: BEWARE/COMMENT S-EFFECTS-DRINK,PROZAC,XANAX,ZOLOFT, posted by saintjames on June 23, 1999, at 12:21:29

I agree with what others have already said about Xanax + alcohol being a dangerous combination. Some people who abuse Xanax use it in combination with alcohol to get just these effects - i.e., extreme disinhibition. And yes, they tend to do stupid things while they're so intoxicated.

For myself, I've taken both Prozac and Zoloft. I've never found that drinking in *true moderation* was a problem for me while on these medications. If you are unable to keep your alcohol consumption moderate, this may be a sign that you have a "drinking problem" and should abstain from alcohol altogether.

I have *not* mixed alcohol and benzodiazepines (Xanax, Klonopin, Valium, Ativan, etc.), as I know what this combination can do to a person.

Now, about this rumor that Prozac causes violent behavior. America is a litigious society; anybody can sue a drug company, and many people are perfectly willing to stoop to burdening our judicial system with frivolous lawsuits. The fact that these suits have been brought means nothing whatsoever.

There have been a few such lawsuits. I can't recall a single case in which any wrongdoing was found on the part of the drug company or the prescribing doctor. Generally what seems to happen is, the family of the individual who committed suicide or became violent makes the claim that the individual had no history of such behavior prior to taking the drug, but then it comes out during the trial that there was a history of violent or suicidal behavior.

Studies have consistently failed to find any increase in suicidal behavior (I'm not sure if they've looked at violent/homicidal behavior) with SSRI use.

Leon AC, et al. Prospective study of fluoxetine treatment and suicidal behavior in affectively ill subjects. Am J Psychiatry. 1999 Feb;156(2):195-201.

Wernicke JF, et al. Fluoxetine and concomitant centrally acting medication use during clinical trials of depression: the absence of an effect related to agitation and suicidal behavior. Depress Anxiety. 1997;6(1):31-9.

Warshaw MG, et al. The relationship between fluoxetine use and suicidal behavior in 654 subjects with anxiety disorders. J Clin Psychiatry. 1996 Apr;57(4):158-66.

Tollefson GD, et al. Absence of a relationship between adverse events and suicidality during pharmacotherapy for depression. J Clin Psychopharmacol. 1994 Jun;14(3):163-9.

Tollefson GD, et al. Evaluation of suicidality during pharmacologic treatment of mood and nonmood disorders. Ann Clin Psychiatry. 1993 Dec;5(4):209-24.

Goldstein DJ, et al. Analyses of suicidality in double-blind, placebo-controlled trials of pharmacotherapy for weight reduction. J Clin Psychiatry. 1993 Aug;54(8):309-16.

Crundwell JK. Fluoxetine and suicidal ideation--a review of the literature. Int J Neurosci. 1993 Jan;68(1-2):73-84.

Wheadon DE, et al. Lack of association between fluoxetine and suicidality in bulimia nervosa. J Clin Psychiatry. 1992 Jul;53(7):235-41.

Beasley CM Jr, et al. Fluoxetine: no association with suicidality in obsessive-compulsive disorder. J Affect Disord. 1992 Jan;24(1):1-10.

Jick H, et al. Comparison of frequencies of suicidal tendencies among patients receiving fluoxetine, lofepramine, mianserin, or trazodone. Pharmacotherapy. 1992;12(6):451-4.

Baldwin D, et al. 5-HT reuptake inhibitors, tricyclic antidepressants and suicidal behaviour. Int Clin Psychopharmacol. 1991 Dec;6 Suppl 3:49-55; discussion 55-6.

Beasley CM Jr, et al. Fluoxetine and suicide: a meta-analysis of controlled trials of treatment for depression. BMJ. 1991 Sep 21;303(6804):685-92.

Fava M, Rosenbaum JF. Suicidality and fluoxetine: is there a relationship? J Clin Psychiatry. 1991 Mar;52(3):108-11.

What we get out of this is that the risk of suicidal ideation emerging on antidepressants is no greater than it would be if you treated the depression with only a placebo.

Also of note is the fact that SSRIs have been shown to decrease aggression. There may be a paradoxical effect in a few people, but if so, it is quite rare.

Teicher and colleagues published a paper in 1993, three years after their initial report of cases of treatment-emergent suicidal behavior on fluoxetine. It's pretty good reading, and they offer a number of hypotheses. (BTW, be assured that the authors do still prescribe SSRIs and consider them good antidepressants.) Some speculations have been made that these events are the result of akathisia, hypomania, or "activation syndrome" induced by the antidepressant; that it's worse to take an antidepressant and not respond to it than to take no antidepressant; or that people who've recently started on antidepressants get increased energy before their mood improves, so that they finally are able to "go through with it."

I should note that even in the cases presented by Teicher et al., confounding factors were present. You can read more about this in the appendix to _Listening to Prozac_ (Kramer, 1993, pp. 304-5). Kramer also discusses some of the outstanding issues.

It's been suggested that patients with histories of impulsive aggression may have an increased risk.

One recommendation in regard to reducing the risk has been to start at the lowest possible dose and increase it gradually as tolerated (Rothschild AJ, et al. Reexposure to fluoxetine after serious suicide attempts by three patients: the role of akathisia. J Clin Psychiatry. 1991 Dec;52(12):491-3).

 

Re: drug mixing; "Prozac causes suicide" rumor

Posted by Haley on June 24, 1999, at 20:31:09

In reply to drug mixing; "Prozac causes suicide" rumor, posted by Elizabeth on June 23, 1999, at 23:44:37

Why don't you also flip the coin and recommend readings and articles that show other results, they are out there a good start would be one of several books by Dr. Peter Breggin, start with Talking back to Prozac,Toxic Psychiatry, and then there are newer ones, ie Brain Disabling Psychiatry

 

Re: drug mixing; "Prozac causes suicide" rumor

Posted by Elizabeth on June 24, 1999, at 20:56:10

In reply to Re: drug mixing; "Prozac causes suicide" rumor, posted by Haley on June 24, 1999, at 20:31:09

Peter Breggin's books are not research; they're just his opinions, which are more political than scientific. He is a rather shady individual.

I did recommend the paper by Teicher and colleagues which discusses possible explanations for the phenomenon (e.g., that it is a form of mania or an extrapyramidal reaction). These are smart guys who I respect and listen to. I also cited _Listening to Prozac_, which goes over Teicher et al.'s original 1990 report (still the most compelling piece of evidence that SSRIs may, in the rare individual, induce suicidal thinking) and comments on it; Kramer, as it happens, does believe that this adverse reaction can happen.

What clinical trials have shown repeatedly is that there's no increase in suicidal ideation in people on Prozac that shows up on the "statistical radar." In other words, if this phenomenon does indeed occur, it is very, very rare.

 

Re: Alcohol & Antidepressants

Posted by Steve on June 25, 1999, at 8:39:55

In reply to Re: BEWARE/COMMENT: personal experience, posted by Sean on June 23, 1999, at 12:03:38

this is a bit of the point, but as far as consumption of alcohol with psychotropic drugs, my experience has been that most antidepressants cause SOME increase in the potency of alcohol, but for the most part was not troubling. HOWEVER, Anafranil (and high dosage of Celexa) do interact with alcohol and in a somewhat scary way, in that I didn't think they were increasing the potency of alcohol while I was drinking, but they were! This lack of insight is the scary part.

 

Blaming the antidepressants

Posted by paul on June 25, 1999, at 10:12:12

In reply to Re: drug mixing; "Prozac causes suicide" rumor, posted by Elizabeth on June 24, 1999, at 20:56:10

Good job, Elizabeth, with the bibliography supporting your comments.

I think it is somewhat ironic that these antidepressants are being blamed for causing suicide. It seems that such research has shown no such causation in a statistically meaningful way. Even if there were this RARE side effect, far more suicides would occur as a result of (presumably untreated) depression.

Perhaps people are less receptive to the idea that depression "causes" suicide (after all, who could one sue?) than they are to the idea that Eli Lilly or some other company (trying to market drugs that, among other things, keep people from killing themselves) is making people do it.

By the way, Elizabeth, good follow-up to my (half-baked) comment on "self-medication" above- I agree.

 

Re: Alcohol & Antidepressants

Posted by Elizabeth on June 25, 1999, at 22:33:16

In reply to Re: Alcohol & Antidepressants, posted by Steve on June 25, 1999, at 8:39:55

>HOWEVER, Anafranil (and high dosage of Celexa) do interact with alcohol and in a somewhat scary way, in that I didn't think they were increasing the potency of alcohol while I was drinking, but they were! This lack of insight is the scary part.

(I'm assuming you mean that this was your experience with Anafranil and high-dose Celexa; no doubt there are some people who didn't have this problem with these drugs.)

Alcohol in general can produce this lack of insight, as you say: very often, people whose coordination is impaired by alcohol believe that they are not impaired or are less impaired than they are.

 

Re: Blaming the antidepressants - to Paul

Posted by Elizabeth on June 25, 1999, at 22:36:48

In reply to Blaming the antidepressants, posted by paul on June 25, 1999, at 10:12:12

Paul, thanks for the kind words!

> Perhaps people are less receptive to the idea that depression "causes" suicide (after all, who could one sue?) than they are to the idea that Eli Lilly or some other company (trying to market drugs that, among other things, keep people from killing themselves) is making people do it.

I totally agree! People need a scapegoat; psychiatric drugs are new and scary to the Luddites in our midst. ;-)

> By the way, Elizabeth, good follow-up to my (half-baked) comment on "self-medication" above- I agree.

I didn't think it was half-baked. I really did think it was a good point. (I like to play devil's advocate too sometimes.)


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