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Interaction between antidepressants and alcohol: signal amplification by multiple case reports
David B Menkes1, Andrew Herxheimer2
1Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
The International Journal of Risk & Safety in Medicine
|September 13, 2014
Summary
Selective serotonin reuptake inhibitor (SSRI) antidepressants combined with alcohol can lead to pathological intoxication, a serious condition involving disinhibition and memory loss. This interaction requires urgent warnings for patients and prescribers.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Neuroscience
Background:
- Alcohol use and antidepressant prescriptions are common globally.
- Limited understanding exists regarding the combined effects of alcohol and antidepressants.
- SSRIs are frequently prescribed antidepressants.
Purpose of the Study:
- To investigate the association between SSRI antidepressant use and pathological intoxication.
- To examine case reports and literature on this interaction.
Main Methods:
- Conducted a comprehensive literature search for interactions between SSRIs and alcohol.
- Collected and evaluated case studies from clinical practices, regulatory bodies, and online forums.
- Assessed evidence for interactions using established criteria.
Main Results:
- Pathological intoxication was identified in 100 of 201 evaluated reports.
- Prominent memory impairment occurred in over half of these cases (53/100).
- Serious adverse outcomes included violence and 8 homicides (resulting in 12 deaths).
Conclusions:
- Evidence suggests a significant, under-recognized interaction between SSRIs and alcohol.
- Further systematic data collection is needed to characterize this syndrome.
- Immediate warnings are necessary for prescribers and patients regarding the risks of pathological intoxication.
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