Medical management of the depressed alcoholic patient

Since the advent of modern psychopharmacology in the 1950s, use of medications in the treatment of many psychiatric disorders has become commonplace. Alcohol use is also widespread. As alcohol can interact with a wide variety of medications to alter drug effects, understanding the interactions between it and psychiatric medicines is important to the efficacious treatment of the depressed alcoholic with these drugs. This article briefly outlines the effects of alcohol and the mechanisms of its interactions with psychiatric medications. The most commonly used classes of psychiatric medicines, including antidepressants, CNS depressants, benzodiazepines, antipsychotics, psychostimulants, and lithium carbonate, are reviewed as to their potential interactions with alcohol. Clinical implications of these interactions are discussed.