# Antidepressants and active alcoholism?



## Kanadiana (Jul 18, 2006)

Hi,

Am wondering what antidepressants a doc would prescribe for an actively drinking alcoholic?

Thanks,

K.


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## foghlaim (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

hi Kanadiana: tho i'm no doc, i can't see any point in a doc prescribing anti-depressants to an active alcoholic as the alcohol would affect the potency and effectiveness of it.

alcohol itself can be a depressant when abused, such as with alcoholism. I would imagin the person wuld have to stop driinking to be able to derive any benefit from such medications.

but maybe david can be more specific.
these are just my thoughs on the topic.

nsa


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## ThatLady (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

I'm pretty sure SSRIs, like Paxil and/or Zoloft have been used to treat depression in active alcoholics. If I remember correctly, they were of some benefit both to treat the depression and to reduce drinking behaviors. I'm sure David will have much more information than I do on this.


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## David Baxter PhD (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

ThatLady is correct. It's definitely not a great aidea to be drinking heavily while using SSRIs because (1) in many ways the effects of the alcohol counteract the benefits that one should get from the medication, and (2) because the SSRI potentiates the effects of alcohol - my non-scientific rule of thumb for clients is that one drink will affect you like two, two will affect you like four, and so on.

Heavy drinking is also depleting vitamin B12 and other nutrients and also affecting hormone levels, which impacts on mood, sleep, and fatigue.


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## foghlaim (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

I'm puzzled having read your response david, you refer to TL post as correct, but having read hers it indicates that antidepressants can be given to active alcoholics to treat depression and reduce drinking behaviours.
while yours would seem to indicate that it's best not to????/

your's puzzled amd maybe ignorant on this subject, but i'm willing to learn. 
nsa


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## David Baxter PhD (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Sorry, what I was trying to say is that based on my observations active alcoholics can be helped by antidepressants but the ongoing heavy use of alcohol limits how much benefits they can get from the medication.

In other words, an SSRI can help an active alcoholic but it can help a whole lot more if they reduce or discontinue drinking. I think most depressed alcoholics are going to eventually need to look at AA or a treatment program to help them either reduce alcohol use or abstain, depending on the person.

The definition of "alcoholism" isn't precise either, of course. I'm really talking about frequency and amoung of alcohol intake.


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## foghlaim (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

thanks for that david... now i don't feel stupid anymore... 



nsa


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## David Baxter PhD (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

You're not stupid, nsa - I probably shouldn't be posting until I've had a cup of coffee to wake up my brain


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## Halo (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Coffee first....type second.....Good Thought!!!


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## David Baxter PhD (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

 Now I just need to write that on a yellow sticky and hang it on my monitor.


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## foghlaim (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

heh heh... i have one here david,, want it?? lol.


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## Kanadiana (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Hey ... coffee first for me too  

Thanks a lot for all the replies here. I am aware of alcohol being a depressant and that drinking messes with it's helping, etc. 

I just mostly wanted to know what kinds a doc might prescribe KNOWING that active drinking was going on because the alcoholic isn't "ready" to stop his high maintenance daily amounts of booze, LONG TIME habit, but severe depression is a big problem right now as is appetite and weight loss. 

The person I'm on about has been convinced to visit a doc about his health and depression which is just progressing deeper each day he does nothing, and am truly worried for him. His depression needs attention now. He's also lost a lot of weight due to loss of appetite, which compounds the depression etc. I think the depression has many roots, including the long term daily, alcohol use and what I know is malnutrition by now, ... and he's not ready to stop boozing, that helping his health and the depression in any way at all, can only boost his health, energy and mood to be able to take next steps.

He works full time still so he's managing to hold that together for now ... but he's progressing backwards and is even scared about how much weight he's lost etc ... this fear is the only thing I can nudge on to get him to follow up on going to the doc right now and reminding him that he's viewing his life and everything and trying to do his days through the heavy veil of depression and that there is help to treat the depression. 

I also wonder about B 12??? shots, or whatever. 

Personally, if I had the power I'd haul him off to a place where he could work at building health up again and only focus on recovering. He has to work, he has bills to pay and to support himself, but at this trend, they'll all be lost too if he doesn't do something to start improving PDQ.

Yes ... this is the person I just separated from. He's not a bad guy, just overwhelmed and in rough shape and I'm trying to help as best I can from a distance. 

We all know that depression can get so bad to the point of a person can't take action for themselves and an outside force is needed to jump in and be the perspective and energy that they don't have (I should know. Been there myself  )

The good news is that he may not always buy what I say, but he often does listen and consider. He's one of those "sceptics" about medications and treatments and thinks like I always used to, it's simply mind-over-matter ... well, it ain't all about mind over matter although thinking goes a long way in improving or worsening the effects of depression, is how I see's it these days.

Thanks again for the replies in here.

K.


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## ThatLady (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Another thing that should be considered here is the penchant of heavy drinkers to replace food with more alcohol. In other words, they'll drink instead of eating. This tendency can cause very serious weight loss and malnutrition syndromes. If such a person is depressed, the problem is accelerated.

While, as I understand it (and David has verified) these people can be treated with SSRIs, until they're willing to look at their excessive drinking as a very real contributor to both the weight loss and the depression, they're not really going to get very far. Controlling the depression will help a little, for a little while, but as long as they continue to abuse alcohol their health will continue to deteriorate. It's a bitter pill for most of alcoholics to swallow, as most have indulged in their own flavor of self-medication (drinking) for a long time. It's become a way of life for them and they're not easily convinced to see it for what it is...a self-destructive path that will only end in disaster.


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## Kanadiana (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Thanks Thatlady ... I personally realize that the antidepressants and food helps can only be a little boost (hopefully a kickstart to dealing with bigger steps like dealing with the booze addiction) ... I just know he happens to need a boost first, as a first step for him, and can only hope facing the addiction will come eventually. For now it's really and truly "baby steps" for him.

I was pleased that last year he did even attend 3 AA meetings then stopped ... so he's heading the right direction, even if tiny steps here and there. He does know, (sometimes ) that booze is creating and has created MANY of the problems he now has, and has had, in past. He does know, most times, his addiction controls him. He waffles, like many do. Maybe one day he'll waffle to the side of choosing what giving up drinking will gain him when he's able to see clearer just what it's really costing him and has cost him ... I have some hope, but the power lays with him. By the way, he's 53 and some habits have been long set.

I honestly feel a potential for him to get above it all. Not at the moment, as is, but the potential is there, if ... miltary types can have a great will and self-discipline when they focus it


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## ThatLady (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

I wish him luck, Kanadiana, as I wish you luck in trying to help him. He's fortunate to have a friend such as you.


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## Kanadiana (Jul 18, 2006)

*Re: Antidepressents and active alcoholism?*

Yeah, me too, and thanks. I have a lot of empathy for people addicted to anything ... I'm a smoker for 39 years now and didn't even give it up for health or anything. I still wish for the desire to want to quit ... I have impulses to want to quit, but those impulses never rise to the level of WANT TO and WILL and DO 

Payoffs for quitting anything have to be good enough and wanted enough to be able to actually quit and stay quit I think. I think a lot of people just really aren't aware or clear of the payoffs but when the lights come on then there's purpose and motivation towards having something you want more, but can't have while addicted. I figure I need a carrot to draw me away from smoking to some more wanted payoffs, not will-power to push me when I don't really truluy want to quit, before quitting would stick 

I actually did quit smoking once for ONE WEEK about 20 years ago! Got totally spacey and watched myself pick up and light a cigarette and suck it back and that was that. Bummer  I obviously wanted to smoke more than not smoke. Didn't have any carrots


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## Kanadiana (Jul 19, 2006)

*Re: Antidepressents and active alcoholism?*

Hi again ThatLady,

You said: 





> While, as I understand it (and David has verified) these people can be treated with SSRIs, until they're willing to look at their excessive drinking as a very real contributor to both the weight loss and the depression, they're not really going to get very far. Controlling the depression will help a little, for a little while, but as long as they continue to abuse alcohol their health will continue to deteriorate.



That's what I was sort of hoping could happen for him at this phase. He's just lost too much weight and am sure a lot of his current depression load is from malnutriton.

By the way, his Mom had major problems with depression, pretty severe at times, and she was also an alcoholic. She was a "nasty mouthed drunk" when drunk. And sudden dramatic suicidal attempts as well at times. It looks like depression is already in the genes and I suspect that much of his drinking was and is about self-medicating that became an addiction and then some. 

When I think of him I often think of that old saying, 

Man takes a drink, 
Drink takes a drink, 
Drink takes a man. (or woman)

I've known alcoholics before, but not witnessed ones who drink from wake-up to sleep. I was stunned to see it in daily action. 

I know there's still potential in him to turn it all around, and the inner drive to do it, if he could turn on that drive. For now though, it don't look like a good prognosis as it's happening unless he gets to the doc asap and at least starts something to help with the depression and appetite, as a baby first step towards ... (time will tell) ... he's too physically depleted and depressed right now.

Anyways ... yes I care, but I can't save him. And i wish i could get over the sensation that I've abandonned him and failed him by leaving because I know my health and everything were sunk there and I had to leave to take care of myself, which I couldn't do there. And yes, my feelings are mixed, call it real caring and concern, and real anger and frustration ... sometimes I want to kick his heinie but I realize he wouldn't understand that anyways ARGH

It was very crazy-making for me with him for the most part, as it would be with any partner trying to accomplish doing a life when only half of the partnership was doing the work. I'm no miss perfection either and when pushed beyond coping I get a little nutsoid too ... not a good blend for a happy thriving healthy type relationship of two people trying to do a life and all that need doiung to make it all work LOL

Thank god I still have a sense of humour ... I found it after I left and collapsed exhausted in my little motel until for a while and got my life going again in my own space and place LOL ... 

I'm very yappy the last couple of days ... catching up maybe?


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## ThatLady (Jul 19, 2006)

*Re: Antidepressents and active alcoholism?*

You didn't fail him, at all, Kanadiana. He's failing himself and everyone who cares about him. It's sad to watch something like this, but to try to help with it from the inside is almost impossible. Sooner or later, if the drinker doesn't take ownership and control of his/her own problem, the problem will drag everyone involved into the muck. Nobody can help when they're mired in the problem themselves. The impetus for change must come from the drinker. All anyone else can do is give support (from a distance) and hope for the best.


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## foghlaim (Jul 19, 2006)

*Re: Antidepressents and active alcoholism?*

kanadiana: i agree with TL, unless the person is willing and reasy to make the changes necessary to help themselves there os nothing anyone can do for them, from personal experience i can vouch for that.

you did the eright thing by leaving and taking care of yourself,, and it's nice to hear that you still care enough to try and help him. but like i said before, it really is up to him.

you take care of yourself ok.  and when \of he's ready to take those steps, then you can offer to help support him, if u still feel that way, if\when the time comes. ok

take care and all the best.

nsa


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## Kanadiana (Jul 19, 2006)

ThatLady and NSA, thank you for your support and encouragement. And understanding. 

I'm only available to him from this point forth as a "friend" and a support from "outside his life". His previous marriages ended for much the same reasons. I should have paid more attention to that and less to what we talked about as how our relationship would be and how we would do it and progress ... the fog of alcohol will manipulate, convince, and tell ya what ya wanna hear and then not follow through after the fact. I really had NO idea just how much and often he drank until I moved in with him and saw it first hand. Nor did I know the states of his life and finances and irresponsibility etc. A shocker all round.

But you know, in spite of the failure, had I not taken the risk and given this a shot with him, if everything would have turned out as we'd said and planned ... it would have been a wonderful marriage and life together. If it had panned out we'd be laughing and enjoying til the cows came home ... that possibility was worth the risk to me in the end, when all is said and done. On that level I'm glad to find out that I didn't pass up something that worked, only too bad I had to jump all the way in to find that out, and am a little worse for the wear. I found out the hard way. Gotta pay more attention to those red flags BEFORE I jump anywhere LOL

My head knows the realities and logic of who and what failed who and what, and even a lot of the why's by now. Sometimes my heart feels like I failed him though ... because I think part of the unspoken part of things was he was unrealistically expecting me to save him from himself and his downward spiral and part of me knew that right from the start. It was to be win/win though  Lose/lose doesn't work.

Anyways, enough of all that for now ... I'm just glad to be on the outside of that life now and have enough of my own depression and major physical issues to take care of to be able to be there much for anyone else right now, especially when "being there" is like flogging a dead horse anyways because I'm not the one with the power to act for him. He is. Like you all say ... and I'm not willing to go down with a sinking ship dragging me under when that would be pointless. I ain't that altruistic and self-sacrificing. Not to the point of total self-destruction. Gurgle gurgle? No thanks. I like air and am still kicking and wish to remain so, and will even toss you any life-jackets I see might help you, but you have to save yourself. Your choice.

Time for coffee refill again


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## Kanadiana (Aug 26, 2006)

Well, I was trying to find this thread for a long time to post a wondeerful update on my ex.

He has been sober now for pushing a month now, after entering a recovery place and program after passing out (fainting - malnutrition and alcohol) a couple of times which resulted in overnight visits to hospital  which scared the crap out of him. I've been helping run his website and other necessary things while he's been in the treatment place. 

I'm thrilled to say that he's seeming quite hooked by sobriety and feeling like his old self, who he hasn't "felt" in many many years and that he's strongly decided about this being a "quit forever" trend. 

For myself, it's amazing to talk to a 'sober" ex, as I've never known him "sober" ... nor has he known me as his sober-self  This is just one month of sobriety, but thank god for the program he's in because it's excellent and prepares him for when he's home again, facing his life, sober. He's eating and gaining back some weight (was severely underweight and malnourished by now  ) 

Will wonders never cease ... there are a lot of happy people, right now, who care about him and have tried, all in our own ways, to nudge and push him closer to this "sobriety" for a long time. He really could NOT have survived much more in the condition he was in, so I say, thank god for the health crisis that forced this to happen, finally. And thank god that he loves "waking up to himself again" and that only sobriety is giving him his self and his life back, therefore he wants this for himself, not for someone else, so its more likely to stick.  

Yes. Excellent news here 

K.


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## Into The Light (Aug 26, 2006)

kanadiana that is such good news! if he wants this for himself and not for others then he'll be working at this. i am happy for you and him


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## ThatLady (Aug 26, 2006)

That's great news, Kanadiana. It's always a good feeling to see a friend find their way to the right path. It can be very sad, and frustrating, to watch them waste their lives on alcohol or drugs. If, and when, they finally come to an epiphany, it can make all the difference in the world, not only for them but for everyone who cares for them.


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## Kanadiana (Aug 26, 2006)

Hi Baseballcap and Thatlady 

You both have that right 

In re-reading my post I think I said my ex has been sober for pushing a month, when actually the program runs one month (but I think the process with this center stays connected with him (whoever) for one year, and he's been sober (since going there) about 3 or so weeks now. It's awesome to talk to him sober. I really had no idea the extent of his drinking before moving in with him. I've never met anyone who drank like he did, from wake up to go to sleep. EVER! 

He called me again today and is very strong and decisive that he'll never drink again ... and I know the strength of his will when he doesn't want to be deterred LOL ... he can do it if he carries on  It all sounds and looks really good right now, but this is so very early in sobriety and he hasn't gone home to "tests" yet. I keep my fingers crossed. 

K.


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## foghlaim (Aug 26, 2006)

great news to read.. kanadiana...  hope all continues to go well for him.


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## Halo (Aug 26, 2006)

That is awesome news Kanadiana.... I will also keep my fingers crossed that he continues on the road to sobriety and to self discovery.


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## Kanadiana (Aug 31, 2006)

Thanks NSA and Nancy 

It's pretty interesting talking to him "sober". And kinda funny too, as I think, "Well Darlin', your booze-brain picked me, now I wonder what your sober brain will think of me as you get to know me and really start to "see me" for the first time (and visa versa  ) "

Well ... it's not really "funny" for the most part since his "booze brain" ;ut me and my life through for quite a while, but it does have it's humorous slant for me at times when I consider things  Believe me, I'm struggling now and then with resentments and hurt. Time wounds all heels though, or oooops  , I mean time heals all wounds (I don't mind showing my little Freudian Slip now and again  ) 

I hope you folks are doing good ...


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