It it OK to Drink While Taking Antidepressant Medication?

Reader’s Question

About 18 months ago my husband began taking Paxil for social anxiety, and it has affected our lives in many positive ways. It has truly been a blessing to see how much more comfortable he is in everyday life. But recently he began to sleep walk after each night he had been drinking. It’s always the same scenario: he wakes in the middle of the night to go to the bathroom but instead of actually leaving the bedroom, he will walk to a corner, or a closet, open a window, and go to the restroom there. He has even wet the bed (or carpet, or floor) in recent months, and I have woken in the night and stopped him before he completed the task at least a dozen times. My fear is that he is doing real damage by drinking while taking Paxil. He will not speak with his doctor about this, as he believes the doctor will either take away his Paxil or his drinking privileges and he is not ready to commit to either of those things. Should I be concerned about what is happening here? Is this simply sleep walking or something more? Is there anything I can do for him?

Our Clinical Psychologist’s Reply

All manufacturers of the current popular classes of antidepressants, including the selective serotonin reuptake inhibitors (SSRIs) recommend that you counsel with your prescribing physician about the potential risks of drinking while taking the medication. Most physicians generally discourage drinking while their patients are on antidepressant therapy. Alcohol is a central nervous system (CNS) depressant and can increase drowsiness during the day, cloud one’s awareness, impair judgement, and cause other CNS dysfunction when taken in combination with alcohol. Further, the beneficial action of the drug itself is likely to be reduced. Some studies have shown that even moderate social drinking while taking antidepressant medication is not a good idea. Drinking while taking antidepressants that are or contain monoamine oxidase inhibitors (MAOIs) can lead to very serious complications such as dangerous spikes in blood pressure and possible stroke.

Treating anxiety disorders and/or depression with drugs alone and not receiving regular counseling with the physician or other mental health professional is also not usually recommended. Whether or not your husband has some apprehension about what the doctor might say, it’s always a good idea to talk these issues over carefully and follow the doctor’s advice.