Posted by ed_uk2010 on January 18, 2015, at 9:05:57
In reply to Re: Smoking and other issues, posted by Zyprexa on January 18, 2015, at 8:14:00
>How does alcohol affect zyprexa and other meds?
It depends on the med... but the interaction is complex because it also differs depending on the type of alcohol intake. There are metabolic interactions .......and other interactions based on the pharmacological effects of alcohol.
Metabolic interactions:
1. Intoxication with alcohol can raise the levels of some meds. This is due to the acute inhibition of certain drug metabolising liver enzymes eg. CYP2E1 and CYP3A4.
2. Regular substantial alcohol use (excluding periods of intoxication) can reduce the blood levels of some meds. This is due to increased production of certain drug metabolising liver enzymes (mainly CYP2E1 and CYP3A4). Note that these are the same enzymes whose function can be inhibited during intoxication.
3. Small amounts of alcohol drunk intermittently do not affect the levels of most meds very much or at all.
4. Liver damage in chronic alcohol abusers may lead to the rise the blood levels of some drugs, and resulting toxicity. Electrolyte imbalances may predispose to cardiac toxicity and confusion.
Due to points 1 and 2, heavy drinkers may experience toxic drug levels during periods of intoxication and subtherapeutic levels (or withdrawal symptoms) the rest of the time. Common meds and psych drugs likely to be affected on a metabolic level by alcohol include acetaminophen (Tylenol, paracetamol), warfarin, some benzos (especially Xanax and Klonopin), Ambien, Lunesta, Remeron, trazodone, some tricyclic antidepressants, Depakote, Tegretol, Seroquel and methadone. Heavy drinking in combination with the likes of Xanax, Klonopin and methadone has resulted in fatalities. Sedation, amnesia, strange behavior, confusion and respiratory depression can occur. The interaction is more than a metabolic interaction because alcohol can also greatly potentiate the central nervous system depression produced by other drugs.
Pharmacological interactions:
1. Regular use of alcohol (except small/occasional quantities) may make antipsychotics less effective. Alcohol should be avoided in psychosis.
2. Alcohol can cause excessive sedation in combination with most sedative drugs, including antipsychotics. This is also the case for drugs such as Zyprexa where there is little evidence of any metabolic interaction.
Alcohol should be avoided with all benzos, opiates, Ambien and Lunesta. People often drink with these meds and think they're fine.... until something bad happens on the occasion they have too much (or when they stop after regular use). How much is too much? Not predictable in advance... Use of alcohol and benzos/sleep drugs together often leads to periods of intoxication, memory loss and disinhibited behavior followed by highly unpleasant periods of withdrawal, followed by further intoxication etc. Obviously, this not the route to health! It does, however, appear to be the standard way that celebrities die young.
3. Regular heavy drinking may lead to liver damage when combined with other drugs which can affect the liver eg. Depakote.
4. Heavy alcohol use with bupropion (Wellbutrin, Zyban) may result in seizures and lack of antidepressant efficacy.
....................................
My advice with Zyprexa is that people who are new to it should not drink at all, nor should people drink while psychotic. Once stable on Zyprexa, small amounts of alcohol socially may be OK, but response may vary. Regular drinking is a bad idea.... and alcohol binges on Zyprexa could be dangerous. Smoking affects the blood levels of Zyprexa far more than alcohol, but alcohol may affect the clinical effects of Zyprexa through other mechanisms. As a result, alcohol excess may be harmful for mental health while on Zyprexa. Smoking, of course, is very harmful physically (as is alcohol abuse!). Chronic lung disease or liver disease is an awful way to die. Smoking E-cigs is much less harmful to the lungs.
poster:ed_uk2010
thread:1075149
URL: http://www.dr-bob.org/babble/20150102/msgs/1075225.html