Amitriptyline and Alcohol: Know The Dangers and Side Effects
Amitriptyline is a prescription medication primarily used to treat depression. It is also prescribed for a variety of off-label conditions, such as anxiety, PTSD, insomnia, chronic pain, and migraines.
Though effective, Amitriptyline comes with potential side effects, and its interaction with other CNS depressants, particularly alcohol, can be harmful. Understanding how this drug works, if you can drink alcohol with amitriptyline, and its associated side effects is key to ensuring safe treatment while minimizing complications.
Amitriptyline (commonly known as Elavil or Vanatrip) is an antidepressant under the TCA drug classification. TCA antidepressants work by blocking the reuptake or reabsorption of serotonin and norepinephrine [1]. This allows the body to process and feel more of the benefits of these two naturally occurring chemicals.
People who have depression often struggle to maintain a healthy balance of serotonin and norepinephrine, so a TCA antidepressant blocker can help treat this condition. While Amitriptyline is FDA-approved to treat depression in adults, it’s off label uses include:
Amitriptyline has been around since the 1960s and was formulated with the hope of treating depression in adults. However, it has since been used to treat many other conditions off-label.
Unlike typical SSRIs that target serotonin, tricyclic antidepressants (TCA) target serotonin and norepinephrine in the synapses by blocking the enzymes that remove those neurotransmitters. If you block the reuptake of these neurotransmitters, there will be an increase in serotonin and norepinephrine for the body to utilize for a longer period. This drug can have an impact on depression symptoms because these two chemicals (serotonin and norepinephrine) are considered mood regulators.
Amitriptyline and other TCAs must be metabolized by the CYP3A4 enzyme. This enzyme can be affected by other drugs, and its rate of metabolism differs from person to person. If the patient has an ultrarapid CYP3A4 metabolizer, Amitriptyline may not be suitable, as rapid absorption will decrease the drug’s effectiveness. Conversely, individuals with slower CYP3A4 metabolizers may not process this antidepressant fast enough, leading to adverse effects. Your doctor should address any unusual variations of this enzyme before prescribing a TCA [1].
TCAs take time to build up in the system, and it can take Amitriptyline 2-6 weeks before the full benefits are felt. With time, Amitriptyline can help relieve depression and other conditions, but it comes with several side effects, ranging from mild to severe. Some of these amitriptyline side effects include drowsiness, dry mouth, dizziness, blurred vision, irregular heartbeat, delirium, glaucoma, and difficulty urinating.
Amitriptyline is typically administered via oral tablets starting at 10mg and reaching up to 150mg. Amitriptyline liquid is also available at doses of 10, 25, and maxing out at 50mg [5]. For safe use, Amitriptyline should be taken at night due to its potential side effect of drowsiness.
Your doctor will adjust your dosage based on the condition you are treating, your age, weight, and individual drug metabolism. This may take some fine-tuning to determine what dosage works best for you. Be sure to communicate with your doctor if you have any questions or concerns as you start Amitriptyline.
As you acclimate to your medication, your doctor may divide your daily doses into smaller amounts throughout the day. This slow introduction can help prevent unwanted side effects from Amitriptyline.
The half-life of Amitriptyline, which is the time it takes for half of the drug’s potency to be processed out of the body, is 10 to 28 hours. The kidneys can take several days to cleanse and excrete this medication [1].
Amitriptyline is considered a relatively safe drug, but you should closely adhere to all directions and prescription doses provided by your doctor. Following your doctor’s guidelines will decrease the chance of adverse symptoms.
Many people seem to enjoy the feeling of being drunk, intoxicated, or tipsy. But it’s important to understand the chemistry behind why you feel this way as it pertains to the co-consumption of other drugs, particularly antidepressants.
Alcohol is water and fat-soluble, which means it passes right through the blood-brain barrier (BBB) and into all the cells and tissues of your body. Unlike most drugs that simply bind to specific receptors (like Amitriptyline), alcohol spreads itself throughout the body, which is why the effects can be felt so quickly [6].
When you ingest alcohol, it must be processed into something else. The alcohol first goes to the gut, and then the liver takes action. The liver turns alcohol into acetaldehyde (a very poisonous chemical) and then converts that chemical into acetate, which can be used for short-term fuel [6].
However, if the body can not convert alcohol to acetaldehyde to acetate quickly enough, the poisonous chemical (acetaldehyde) will build up in the body and damage other cells [6].
When we drink and take other drugs like Amitriptyline, our bodies have competing demands to process both the effects of alcohol and the effects of the antidepressant.
Because the body is potentially overloaded with chemicals to process, you might feel the effects of drinking faster when on Amitriptyline. The amount of alcohol consumed is directly proportional to how hard the body must work. The more you drink, the more stress you put on the kidneys and liver, which increases the risk of cell damage.
In short, it is not advisable to mix Amitriptyline with alcohol due to the risk of damage to your cells and the risk of quicker inebriation, which can lead to blackouts and alcohol poisoning.
Alongside the dangers that Amitriptyline can have on your body’s processing of alcohol. The Amitriptyline and alcohol interaction can reduce the medication’s effectiveness and increase adverse side effects.
Amitriptyline, by itself, can have a range of negative side effects. Three types of Amitriptyline side effects can occur: Alpha-adrenergic, anticholinergic, and antihistamine side effects. Below are the associated symptoms of each type of adverse Amitriptyline side effect:
These effects occur when the drug blocks alpha-adrenergic receptors, which can cause issues regulating blood pressure and heart function.
These effects occur when a drug blocks acetylcholine, a chemical that helps with our muscle movement, digestion, and memory.
These effects happen when a drug blocks histamine receptors to manage allergic reactions, but it can also lead to drowsiness.
In rare cases, Amitriptyline can have severely adverse effects, including:
All of these side effects may be negatively impacted and exacerbated by the added effects of alcohol. If you are experiencing adverse symptoms with your Amitriptyline medication, talk to your doctor as soon as possible.
So, can you take amitriptyline after drinking alcohol?
While it may not have lethal consequences, the consumption of these two substances can have short and long-term health ramifications.
Even a low dose of amitriptyline and alcohol is not recommended by doctors. Social situations can make this habit hard to break. It’s important to discuss your lifestyle and alcohol use with your doctor for clear guidance. Based on your dosage and condition, they can advise whether any alcohol consumption is safe for you.
While wine may seem like a less potent form of alcohol, it still contains ethanol. The body must process all forms of ethanol via the liver. Overconsumption of wine, especially while taking Amitriptyline, can overwhelm the liver and kidneys. If your body can not process alcohol fast enough, it will retain the poisonous chemical of acetaldehyde, which can cause cell damage. Just like any other type of alcohol, wine can increase the risk of adverse effects when combined with Amitriptyline and lower its efficacy.
One of the most common symptoms that escalates with Amitriptyline and Alcohol consumption is fatigue.
Amitriptyline already has side effects of fatigue and drowsiness – which is why most people take their antidepressants before bedtime. Alcohol is also a CNS depressant with the ability to make one feel sedated and drowsy. The combination of these two substances could lead to extreme drowsiness.
It is not advisable to take Amitriptyline and alcohol and drive or use heavy machinery due to this impairing side effect.
Amitriptyline is a versatile antidepressant that, while effective for treating depression and other conditions, comes with potential risks, especially when combined with alcohol. Along with these risks, the potential for abuse of both prescription drugs and alcohol can create long-term damage to your health and overall well-being.
If you or someone else is struggling with addiction to prescription drugs or alcohol, California Detox offers personalized treatment administered by compassionate clinicians. Our treatment programs provide:
Find effective treatment for drug and alcohol addiction today by calling our team at (888) 995-4208.
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