Alcohol decreases the effect of antidepressant medication. Patients are not always warned of the risks. Yet many alcoholics need treatment for depression. Dr. Fatma Bouvet de la Maisonneuve explains why.
Are all alcoholics depressed? Yes, in my opinion and from my experience as a psychiatrist. But many former alcoholics and other doctors think not. Personally I almost always find depressive elements in alcoholic illnesses.
Patients often ask me this question: “Doctor, am I drinking because I am depressed or am I depressed because I drink? “For me, this is a pivotal question . In reality, the two situations coexist. It should be noted that 65% of women who have difficulty with alcohol and 44% of men have experienced at least once in their lives an episode of depression or anxiety.
The dialogue between doctor and patient about depression is fundamental because it will make it possible to treat both problems at the same time: that of alcohol and that of depression. The mistake that should not be made is to neglect alcohol consumption in order to treat only depression. The effectiveness of antidepressant drugs is halved when taken with alcohol and their sedative effect increases. At the same time, alcohol appears to be an antidepressant in the short term, but is depressogenic in the medium and long term. It therefore aggravates the depressive state, disrupts sleep and exacerbates anxiety.
Unfortunately, patients are not always warned of the risks of the combined use of antidepressants and alcohol. As a result, lack of improvement may lead them to drink even more, as they feel frustrated.
It is therefore important for the doctor to diagnose and treat depression, while at the same time warning the patient of possible interactions with alcohol.
Ideally the patient should stop drinking or at least reduce his or her consumption. Motivational levers can be used to help him or her and, if necessary, anxiolytics and specific medication can be prescribed when alcohol is stopped.
This will allow him to feel the effect of the antidepressants and begin to restore his positive mood. He will therefore be less sad and less inclined to seek euphoria with alcohol