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Family Physician
Family Physician, Doctor (MD)
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Experience:  Emergency Medicine and Family Practice for over 26 years
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Paxil and alcohol

Customer Question

Is it Okay to Have an Occasional drink while taking 20mgs Paxil? What are the effects of drinking while on Paxil?
Submitted: 11 years ago.
Category: Health
Expert:  David Cuff replied 11 years ago.
Remember that the physiological cause of depression lies in the nerve cells in the brain. When the levels of the brain messengers called neurotransmitters are too low, messages can't cross the gaps between brain cells, and communication in the brain slows down. While there are about 100 different kinds of neurotransmitters, the most important ones that seem to be related to depression are serotonin, norepinephrine, and dopamine. When levels of these chemicals are too low, you get depressed. Drugs that boost these chemical levels can relieve depression. Drinking will defeat the effects of Paxil.

SSRIs target the neurochemical serotonin. When serotonin is released in the brain, it is reabsorbed by the brain cells to be used at another time for another message. This process of reabsorbing is called reuptake . If you're depressed, you don't have enough serotonin and other neurotransmitters, so by interfering with the reuptake of these chemicals, more is available to help send messages and boost communication. A drug that can interfere (inhibit) the reabsorption (reuptake) of serotonin alone is "selective"—hence, the selective serotonin reuptake inhibitors. Alcohol has the exact opposite effect it is a depressant.

What makes the SSRIs so attractive is that the older antidepressants tend to affect many different neurochemicals and processes in the brain—and the more systems that are altered in the brain, the higher the chance of unpleasant side effects. SSRIs, however, are highly selective, targeting only the problem neurochemical while leaving other brain systems alone.

If you lived in a brand-new custom home and a lightbulb burned out on the second-floor landing, you wouldn't call in an electrician to rip out all the wiring in the walls—you'd just replace the bulb. There's just no need to disrupt all the activities in the entire house to fix one simple problem on the second floor.

It's the same way with depression. If you've got a malfunction in one neurotransmitter system, there's really no need to take a drug that will interfere with other neurotransmitter systems and receptor sites throughout your brain. But for many years, antidepressant drugs did just that.

No one knew how to design a drug that would home in on the lightbulb and ignore the wiring in the rest of the house. Yet it appears that some people do seem to get depressed as a result of something as specific as a malfunctioning serotonin system—the neurological equivalent of a burned-out lightbulb.

For 10 years, scientists searched for this specific drug, looking at different models of nerve transmission and tailoring chemicals to affect these basic processes. They finally found what they'd been looking for in Prozac. With this chemical, scientists finally had a way to simply replace a burned-out bulb without rewiring the whole house.

The beauty of this new class of drugs is that they're so specific. So don't drink period, your taking Paxil for a reason ...let it work give it three to four weeks to kick in and adjust the dose with your doctor if you don't feel better. Drinking will only make you feel better for a bit then the bottom will drop out. Please don't drink.

Customer: replied 11 years ago.
Reply to David Cuff's Post: I will take your advice! Thank you very much!

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