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Question about zoloft an alcohol. I took zoloft for 10 years

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For a physician Please Question about zoloft an alcohol. I took zoloft for 10 years I now don't take it anymore thankgod; however, I started drinking with zoloft when i was 17, i am now 27. I did drink moderate amounts of alcohol sometimes more than moderate...i would say that when i was late teens early twenties i would binge drink sometimes. But over the last 5 years of zoloft useage I would only combine smaller amounts...a few drinks a couple times a week sorta thing...I never really blacked out or anything per say. I feel that I am brain injured now however. I don't feel my memory is as good. I got an MRI done on my brain and it shows no atrophy and i rarely drink any alcohol anymore. I do hypothesize that my brain is messed because alcohol temporarily increases serotonin and zoloft does as well. it could have resulted in receptor damage that would not show up on an MRI. Many many doctors have assured me that while not advisable the drinking with the antidepressant has not resulted in anything permanent
Submitted: 5 years ago.
Category: Mental Health
Expert:  TheGermDoctor replied 5 years ago.

Customer-

 

I am not clear what your question is What specifically would you like to know.

Thanks

Customer: replied 5 years ago.
Well if I can recover from whatever damage happened?? or if there was no damage? I would like to know so i can put it all behind me...i was never an alcoholic i just drank like a normal young person would and never received a strong warning about it from my dr.
Expert:  TheGermDoctor replied 5 years ago.

If you did develop brain injury from alcohol, mixed with other medications, and it occurred years ago, , you may expect to see some improvement with time, if you are no longer drinking. But some damage , if there was any, likely would be irreversible.

 

I think the important thing is to prevent further damage, by avoiding things that can be harmful, like drinking more.

 

If you wanted a more objective assessment, then detailed neuropsychiatric testing can be done to assess your memory and cognitive functioning. But there likely is not much else that can be done treatment wise.

 

Good luck.

Always ask if you need clarification/more information.


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Please note that answers are for information only, do not take the place of an assessment by your doctor,
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Customer: replied 5 years ago.
Well how come I have been repeatedly told by many dr's here and also psychiatrists that i have seen in teh past and my family Dr that I would not have any damage in addition to damage that would be caused by alcohol alone.
I do not understand and this is extremely bothersome to me. Why do most people tell me that alcohol is the drug that would cause brain damage...and that it has nothing to do with the zoloft mixed in
Expert:  TheGermDoctor replied 5 years ago.

Customer-

 

I have no way of knowing if you had any damage done or not- I was just commenting on your post that said you suspected brain damage. If you have memory impairment.. then that is a sign of brain injury. Only by seeing you, examining you, or doing objective tests can that diagnosis be confirmed. If you don't have any objective findings- then great.. no worries...

 

 

And from your medications, it is alcohol that would be more toxic to brain function rather than Zoloft. Certainly the combination can potentially make things worse but there is no evidence Zoloft would lead to memory impairment.

 

Good luck.

 

Always ask if you need clarification/more information.


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Customer: replied 5 years ago.
<p>I understand what you are saying but in what way would alcohol and zoloft together make things "worse" . How does the combination cause damage? and why have I been told that it doesn't cause damage that is above and beyond the alcohol damage alone. I have been told this by a number of sources. I am just very confused as to what to believe. Would an MRI show damage? Also I found a peer reviewd journal article showing that people on antidepressanst took more alcohol than those not on them. I work in a hospital and know that doctor's continue to prescribe SSRI's to those who drink alcohol...isn't that unethical if it causes damage?</p>
Customer: replied 5 years ago.
When you say there is no evidence that zoloft would lead to memory impairment to you mean that the zoloft in combination with the alcohol would not lead to any additional memory impairment above and beyond the alcohol alone as we all know alcohol is a neurotoxin
Expert:  TheGermDoctor replied 5 years ago.

I should have been more precise- There is no data to state that the combination makes things worse as far as memory impairment long term-- if you have memory impairment, it may be due to alcohol ( or it may be due to something else that you haven't told me about- like a head injury, or other drug use).

 

Zoloft is not been shown to cause brain injury. I was just getting at the combination can cause more sedation and has a combined effect in n that way, but specifically related to memory, Zoloft should not be a problem.

 

That is why people have told you that if you do have damage it is more likely from alcohol.The botXXXXX XXXXXne is , you likely cannot change the past, just don't drink excess alcohol now and you should not have progression.

 

It is not unethical to use SSRIs in people who need them, even if they drink alcohol- The concern as I noted would be excess sedation and mental status depression- but there are risks with any medications.

 

Good luck.

 

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Customer: replied 5 years ago.
Thanks for the answer Can i ask one last thing. I never had a head injury and I did use tylenol 3 for back pain for 3 years but not in excess ...1 or 2 per day. and almost never in combination with alcohol. NO other drugs ..
The last thing was i never was unconciouss and not breathing or anything like that from alcohol and zoloft.
So when you said "specifically related to memory, zoloft should not be a problem" you meant in combination with zoloft right? If i never passed out and was not breathing and didn't drink excessively like an alcoholic...more like a 20 something year old who was just trying to fit in and had some drinks here and there...i should not have damage from the combination right? If there is memory impairment it is from the alcohol?
Customer: replied 5 years ago.
I am sorry I asked so many questions but I do have OCD and I get very obsessed an specific with my questioning but i am managin without medication and I am doing fairly well.
Expert:  TheGermDoctor replied 5 years ago.

1-2 Tylenol with codeine would not likely cause a problem , even for 2 years.

And yes, I was referring to the combination of Zoloft with other drugs/ alcohol.The Zoloft should not have caused any problems.

 

Good luck.

 

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Customer: replied 5 years ago.
One last thing and then I will stop asking. The tylenol 3 that I took was sometimes after drinking alcohol...but not too often. and i made sure i waited an hour per drink...there was definately no sedation from alcohol when i took tylenol 3...this would not change your answer right?
Expert:  TheGermDoctor replied 5 years ago.

If you did not become overly sedated, then no, I think it likely would not have had an impact and does not change my thoughts above.

 

Good luck.

 

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If I have answered your question, please click the ACCEPT button so I can get credit for my work.


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TheGermDoctor, Doctor
Category: Mental Health
Satisfied Customers: 1549
Experience: 17 years of experience as a physician, Board Certified
TheGermDoctor and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
When you refer to over sedation what do you mean. Do you mean like a glascow coma score of say under 14. or do you mean like actual coma of score under 8 to cause damage to the mind. Because I have seen people come into the hospital with poly drug overdose and they are GCS of well under 15. I was NEVER like that.
Expert:  TheGermDoctor replied 5 years ago.
By oversedation I mean to the point where a level of consciousness is impaired- it does not sound like this happened to you.
Customer: replied 5 years ago.
I will add additional bonus for answering . I was going to ask have you ever heard of anyone wih serotonin syndrome from alcohol / zoloft. I have not
Expert:  TheGermDoctor replied 5 years ago.

Not just alcohol with Zoloft.

I have seen serotonin syndrome, but with other medications used concurrently.

Customer: replied 5 years ago.
So even sometimes back years ago when i had larger amounts of alcohol it wouldn't have likely caused serotonin syndrome with just zoloft alone. ?? it would likely take other meds too. I have never heard of it and as i said i work in hospital and see many people mixing the two.
Expert:  TheGermDoctor replied 5 years ago.
Nope, it would not have caused serotonin syndrome.
TheGermDoctor, Doctor
Category: Mental Health
Satisfied Customers: 1549
Experience: 17 years of experience as a physician, Board Certified
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Customer: replied 5 years ago.
I hate to say this but everything you say is true right it is not that you are just trying to make me feel better>???
Expert:  TheGermDoctor replied 5 years ago.
I don't write things just to make people feel better... I always try to be honest with my asnwers.,..
Customer: replied 5 years ago.
<p>it was 3 and a bit years of tylenol 3 usage ...in one of your responses I saw you wrote 2 years isn't enought to hurt you....My dr. said there would be no brain damage from that as many people have chronic pain and take it much more than me....and even though itook it sometimes after alcohol i didn't directly combine it and that there woulnd't have been much of any reaction....as i was not sedated...he said no brain damage</p><p> </p><p>that doens't change your answer</p>
Expert:  TheGermDoctor replied 5 years ago.
That still does not change my response.
Customer: replied 5 years ago.
I was going to say that the tyelonl 3 and zoloft was together ...that doesn't matter right..people are prescribed those together all the time..you took that into account when you answered my question?
Customer: replied 5 years ago.
I was going to say that the tyelonl 3 and zoloft was together ...that doesn't matter right..people are prescribed those together all the time..you took that into account when you answered my question? well i mean not taken at exactly the same time but the tyelenol 3 was during the years i was on zoloft
Expert:  TheGermDoctor replied 5 years ago.
Yes, it still would not change my answer.
Customer: replied 5 years ago.
I will provide a bonus for this question > I was wondering what you know about hippocampus atrophy and depression . I had a MRI done and it showed no hippocampal atrophy. that was 6 months ago..i have since been off zoloft for 2 monnths and the repedative thoughts that I get related to my OCD have gotten stronger...i am hanging in there but it is very difficult...i am under stress i would say. I wish i could turn it off...However I do not want to continue to take drugs to hide from my probelsm my whole life...and i am surviving...Howerver I don't want to give myself additive brain damage by having high levels of cortisol damaging my hippocampus...is there a test to measure cortisol?? Would the stress of the last couple months have damaged my hippocampus permanently anyways...i still go to work and do things..maybe not quite as much and it is hard sometimes to keep it together...but i am doing it.
Expert:  TheGermDoctor replied 5 years ago.

Yes, there are tests to measure cortisol- a first am blood cortisol level is a test commonly done to check for excess cortisol and 'Cushing's" syndrome.

 

It would be unlikely for stress alone to lead to a marked increase to the point of a pathologic amount and extremely unlikely for this to cause any structural brain disease.

I think you clearly remain quite anxious about all this, and this as well as OCD as your main issues that need to be addressed.

 

Good luck.

 

Always ask if you need clarification/more information.


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Please note that answers are for information only, do not take the place of an assessment by your doctor,
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Customer: replied 5 years ago.
but do i really want to go on to a antidepressants for the rest of my life...because if i go back on that is waht i am looking at ....i want to deal with issues without it...
My typical OCD issues relate to brain damgae...i constantly think about brain damage....when i am at work i worry about past indescretions that caused brain damage...i would say my recurring thoughts about depression and brain damage occur every couple of minutes...i can block them to some extent but they do come back over and over again every waking hour of the day....when i take an antidepressant they don't...
the main reason that i don't take an antidepresant now is that i believe that IT in the long run could contribute to memory loss etc...as not enough is still known about complex brain chemistry...
...so for me it is a very tough choice...
--i mean i clearly have some mental problem if things come back to bother me every waking hour of the day right? even if i can contorl them to some extent?
Expert:  TheGermDoctor replied 5 years ago.

Some people do fine on SSRIs for years - there is really no hard and fast limit to how long you can stay on them. The alternative in your case would clearly be some intensive counseling and therapy.

 

Yes, you are clearly obsessed about this issue... Frankly I doubt you will manage without some medical therapy, but then again I only have a very limited impression from your responses. I would not see taking pills as a bad thing- it's just like any other problem that medications can help. And no, there is NO reason to think it would have long term effects like memory loss.

 

Good luck.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


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TheGermDoctor, Doctor
Category: Mental Health
Satisfied Customers: 1549
Experience: 17 years of experience as a physician, Board Certified
TheGermDoctor and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
So you know of people that have taken ssri's for 20 or 30 yerars and are able to still do complex university courswork...and hold great careers like dr's , engineers etc???
Customer: replied 5 years ago.
R u still online/
Expert:  TheGermDoctor replied 5 years ago.

Sorry- I was offline for a while..

 

But yes, I know of many people who have been on SSRIs for many years and lead very productive lives. In fact there is a high recurrence rate of symptoms when SSRIs are discontinued.

Customer: replied 5 years ago.
Are u able to answer my last post
Customer: replied 5 years ago.
productive i get...but are they smart with good memories able to complete high level university studies after years of those drugs...like chemistry calculus Hard things
Expert:  TheGermDoctor replied 5 years ago.
Yes- there are many professionals who function at a very high level and take SSRIs - you really are obsessed about this, but it does not necessarily affect your thinking or memory/
Customer: replied 5 years ago.
and who will be on them their lives from young to old...? and still do well
Expert:  TheGermDoctor replied 5 years ago.
Please rewrite that last question clearer.
Customer: replied 5 years ago.
I mean that there are professionals who take antidepressants....have taken them since a young age, then went to university, did well, and continue to take them and continue to do well, and who will most likely be on them their entire lives.
Expert:  TheGermDoctor replied 5 years ago.
Yes, there are, as I have noted above. This is not uncommon.
Customer: replied 5 years ago.
Hello I was going to ask one more thing..the tylenol with codeine i took was not tyelol 3..my mistake..that was a misprint. It was tylenol 1...tylenol 1 has 300mg acetaminophen and 8mg codeine and 15mg caffeine....i took sometimes 4 of those at once...most of the time 3 at once....I never exceeded 4 grams of tylenol in a day...my dr thought it was fine to take the tylenol 1 over 3 because that way i was restricted in ever taking too many and would less likely lead to addiction. So most of the time i took 900 acetaminophen and 24 mg codeine...sometimes i took 4 even though i was supposed to take 3 which would be 1200 acetiminophen...i have had liver enzymes checked off and on over that time and never had any issues..
Could that have caused damage in my mind (having higher levels of acetaminophen and zoloft trying to be metabolized at the same time)??
Even though i never exceeded recommended intake...and as i said before most of the time i took the equivalent of 1 or 2 tyelol 3's per day...which would be 6 - 8 tyelnol 1's with 300mg acetaminophen...and many days i didn't take any!
Expert:  TheGermDoctor replied 5 years ago.

This still does not change anything- the acetaminophen would not affect mental function.

You remain obsessed over this and I think you need ongoing counseling- and from your responses here I think it is highly likely will need ongoing antidepressants/ anxiolytics for this problem...

 

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Customer: replied 5 years ago.
I know...i just got home from work and am worried again. There are elderly people that take 4 grams of tylenol per day right and also ssri's?? and they have weaker livers than me....and they are fine right? The ssri is not reaching toxic levels because of competing drugs on the liver?? Couldn't the acetaminophen affect mental function indirectly by causing an increase stress on liver which then caused increase zoloft or decreased elimination of zoloft and then effect function?
Expert:  TheGermDoctor replied 5 years ago.
No, that does not happen.
Customer: replied 5 years ago.
Ok thanks. I sometimes did take up to 4 grams of tylenol a day..for a number of days but then went back down to 1 gram or 2 grams...some recent studies show elevated aminotransferase in healthy people taking the max dose over 2 weeks only. I also took ibuprofen with the tylenol a number of times...sometimes 800 mg ibuprofen but only i would never take max dose of both drugs together for a prolonged period...as well as zoloft and pantoprazole which i take for my stomach....couldn't all these drugs mixed at various levels over the years have led to toxicity...over the 3.5 years where i combined them...i only had liver enzymes checked twice...and there weren't any eleveations then...but my usage varied so much that i worry that when they checked them they weren't high but then later they were high....if there was any serious problem it would have been caught on the liver tests right? Even though at that time the test was taken i may not have been using much of tyelnol or ibuprofen...The enzymes would remain elevated if too much tyelnol and ibuprofen was taken in combination wiht other things too, and they would stay elevated for a while even after a decrease in the drugs right? like weeks???
Expert:  TheGermDoctor replied 5 years ago.

Tylenol and other medications may cause a transient elevation in your liver transaminases- It would not have any affect on your memory, and mental function which you remain obsessed about.

 

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Customer: replied 5 years ago.
Hello is it unlikely that taking all those things together even if i took 4 grams of tyelnol sometimes over 16 hours...but not exceeding 4 grams in 24 hours..as the direction on the bottle says 1000mg every 4 - 6 hours to a max of 4000 daily...would cause serotonin syndrome?? I mean couldn't serotonin syndrome be caused if the zoloft was competing for metabolism with the tylenol and because the tylenol was high...it caused the SSRI to be metabolized slower and increased its concentrations to the point of serotonin syndrome...When i think about it there were various times over the 3.5 years i took all those things together when the tylenol with codeien had differing effects on how i felt. Sometiems i would feel a little euphoric and pain relief..and sometiems i would feel a little confused for a couple hours ...Could that be a serotin excess happening.. Or is what i'm saying just not possible considering my liver enzymes where never elevated for any prolonged period of time. I am just interested in knowing how the liver deals with those multiple drugs...
Expert:  TheGermDoctor replied 5 years ago.

It is unlikely at this point that you have any complications form Tylenol or SSRI usage. Period. Serotonin syndrome as well is a non-issue as previously discussed.

 

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Customer: replied 5 years ago.
It just doens't work that way. You know of many people who take max dose of tylenol for prolonge periods (for arthritis ect) along with other prescribed drugs like ssri's and heart meds etc and who are also older than me and never have serotonin syndrome..it is a non issue as you said...it doesn't happen right?
Expert:  TheGermDoctor replied 5 years ago.

Correct.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.
POSITIVE feedback & a BONUS are warmly appreciated.
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Customer: replied 5 years ago.
What about the fact that i drank alcohol too at varying amounts. often i would take tylenol after waiting 1 hour per drink
Expert:  TheGermDoctor replied 5 years ago.
Still would not lead to serotonin syndrome.
TheGermDoctor, Doctor
Category: Mental Health
Satisfied Customers: 1549
Experience: 17 years of experience as a physician, Board Certified
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Customer: replied 5 years ago.
If there was a gap of a couple of years between testing of liver enzymes couldn't there have been a point during that time where there was liver disease and it did interfere with the metabolism of zoloft but then when the test was done a year later ....the liver function had returned to normal. So it was missed? Or is it not really possible to have had liver enzymes return to normal if there was such damage to the liver a year or so earlier to the point that it hadinterfered with the metabolism of medications
Customer: replied 5 years ago.
I will add bonus for answering thanks
Expert:  TheGermDoctor replied 5 years ago.

Sorry for the delay- I was away from my computer.

 

Yes, there is certainly a possibility that at times your liver enzymes may have been elevated, but that still would not be expected to precipitate serotonin syndrome- this occurs with drug interactions and very high drug overdoses. The degree of liver impairment you are hypothesizing ( clearly not extremely advanced) would not likely have had enough impact for serotonin syndrome. And I am not convinced you even has serotonin syndrome- so you just seem to be obsessing over this without much real objective reason.

Customer: replied 5 years ago.
<p>So you are quite sure that there is no way that i could have had serotonin syndrome based on what i told you. Even though there could have been 2 years between liver function tests and at some time during those two years the liver could have been damaged...and then recovered before the next test...and not shown damage. But youare sure that the level of damage required to cause serotonin syndrome would then show up on liver tests a year later because the liver damage would be so severe?</p><p>Even if you hadmini serotonin syndrome...not too serious ,....over and over again that would not cause long term brain damage?</p>
Expert:  TheGermDoctor replied 5 years ago.
Yes, I still do not think this is a plausible scenario.
Customer: replied 5 years ago.
Hello i have a question > i willa add bonus

I used to take pantoprazole which is a proton pump inhibitor daily.
but over the past year i have taken it a couple times a week as i have not needed it daily...that would not have hurt me right?
Expert:  TheGermDoctor replied 5 years ago.

Nope-

There is nothing wrong reducing the dosing frequency of PPIs if you do not need them daily.

 

Good luck.

 

Always ask if you need clarification/more information.


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