Antidepressants like citalopram and sertraline can help people overcome depression. At the same time, they can have adverse reactions when mixed with other drugs. People who are prescribed medication for depression should be careful about which other substances they combine with their meds.
4 Drugs that Don’t Mix with Antidepressants
When your doctor prescribes you anti-depression pills, they should give you a rundown on the drugs that don’t mix with antidepressants. However, some doctors leave this research up to the patient. The problem is that many people don’t actually do the necessary research. That’s why we’ve put together this “mixing drugs guide”. It’s our intention to outline the information you should know about mixing medication for depression with other drugs.
What are Antidepressants?
When talking about antidepressants, we’re talking about a few specific classes of drugs. They are as follows:
These drugs increase the amount of serotonin and norepinephrine in the brain. Both of these chemicals play a key role in your mood, which is why SNRIs can be used to treat mood disorders like depression and anxiety. Other medications and recreational drugs also raise serotonin and norepinephrine levels in the brain. Taking those drugs can cause problems for someone who already has SNRIs in their system.
- Common SNRIs include:
- Desvenlafaxine (Pristiq)
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
SSRIs work to regulate the amount of serotonin in our brain. Although serotonin is partially responsible for our ability to feel happy, too much of it can be a bad thing. Mixing SSRIs with other serotonin-boosting drugs can cause physical and psychological problems for the user.
Common SSRIs include:
- Citalopram (Celexa)
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Escitalopram (Lexapro)
- Fluvoxamine (Luvox)
- Paroxetine (Paxil)
TCA antidepressants are prescribed much less than they used to be. This is due, in part, to the fact that they have more side effects than SSRIs. Similar to other medications for depression, however, they regulate the serotonin cycle in the brain. As a result, they can cause an overflow of serotonin if mixed with certain substances.
Common TCAs include:
- Protriptyline (Vivactil)
- Desipramine (Norpramin)
- Trimipramine (Surmontil)
MAOIs don’t target the production or re-uptake of serotonin in the same way that other antidepressants do. They actually target an enzyme in our body called “monoamine oxidase”. This is the enzyme that breaks serotonin down. By reducing the amount of that enzyme, MAOIs enable the brain to receive more serotonin than it would otherwise.
MAOIs are not prescribed as often as they used to be. One of the reasons for this is that monoamine oxidase is kind of important for our bodies. It helps to flush out the unwanted chemicals that are often found in alcohol and other drugs. If someone drinks alcohol or uses drugs while prescribed to MAOIs, their body may not be able to break it down. This can have severe negative consequences.
The MAOI class includes:
- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
- Selegiline (Emsam)
Mixing Anti-Depression Pills with Other Drugs
If you take antidepressants, there are certain substances you need to avoid. The drugs outlined in this article can have dangerous consequences when mixed with depression meds.
It is important to remember that “mixing” doesn’t necessarily mean using both substances at the same time. Drugs will interact with the other substances that you already have in your body. If you take Prozac, for example, you will accumulate the drug in your blood, liver and other organs over time. Therefore, you shouldn’t take any drugs that have negative interactions with Prozac until you are sure it has been flushed out of your system entirely.
Here are a few drugs that you should never mix with antidepressants:
1. Never Do Coke While on Antidepressants
People who are prescribed pills for depression shouldn’t use cocaine. Period.
Essentially, antidepressants are used to correct chemical imbalances within the brain.
Our bodies produce chemicals that are sent to our brains in order to help us feel happy. These chemicals include serotonin and dopamine. When the brain receives too much or too little of these chemicals, depression can occur. Anti-depression pills work to make sure we have the right amount of serotonin and dopamine in our brain at all times.
Cocaine, on the other hand, causes sends a whole lot of serotonin to our brain all at once. This is why people like it. The rush of serotonin makes them feel euphoric for a few minutes. When someone mixes coke and antidepressants at the same time, however, things can get dangerous.
Mixing cocaine with antidepressants is risky because it can cause “serotonin syndrome”.
What is Serotonin Syndrome?
Serotonin syndrome happens when the body receives more serotonin than it can handle at one time. The symptoms of serotonin syndrome usually include:
Both coke and antidepressants can cause serotonin syndrome by themselves. However, the likelihood of this increases when they are used in combination with one another.
2. Avoid Mixing Antidepressants and Alcohol
Doctors and manufacturers strongly advise patients not to drink alcohol while taking antidepressants. Someone who drinks regularly while prescribed medication for depression is likely to find that the drug does not improve their mood or mental state and is better off abstaining from booze.
Additionally, drinking alcohol while on antidepressants can be downright dangerous. The health risks vary depending on which medication the individual is prescribed:
SSRIs: People who take SRRIs shouldn’t drink alcohol for a number of reasons. Drinking while on Lexapro, Celexa or Zoloft isn’t deadly for most people. However, it can cause extreme drowsiness and increase the risk of a blackout.
Fluoxetine: Drinking while on Prozac (and other SSRIs that contain fluoxetine) is especially dangerous. Mixing Prozac and alcohol can increase the user’s heart rate and blood pressure to unsafe levels. It can also make depression much worse if done regularly.
MAOIs: It is highly advised not to drink booze if you’re taking an MAOI antidepressant.
These drugs prevent the body from breaking down an enzyme called tyramine. Too much tyramine can have a negative effect on our heart, blood and other parts of the body. Unfortunately, there is a lot of tyramine in alcohol.
As a result, mixing MAOIs with alcohol can cause a spike in heart rate and blood pressure. This can lead to long-term heart problems and increased risk of heart attack. On top of this, the mixture can lead to serotonin syndrome.
TCAs: Particularly early on in their prescription, TCA users are advised not to drink at all. The main reason for this is that the mixture can cause the individual to get drunk much faster than they would normally. This can greatly increase the risk of a blackout.
Are There Alcohol-Safe Meds for Depression?
Unfortunately, antidepressants do not offer the same psychological benefits if you drink alcohol. People who are on medication for depression should abstain from drinking if they want the medicine to have an optimal effect.
3. The Dangers of Combining MDMA and SSRIs
The relationship between MDMA (commonly known as “Molly”) and antidepressants is quite interesting. People who take Molly often use SSRIs to combat the hangover they feel for a few days afterward.
Essentially, MDMA spikes the serotonin and dopamine levels in a person’s brain. This enables them to feel euphoric for several hours. Once the drug wears off, their neurotransmitter levels drop far lower than they were beforehand. Antidepressants are used in a strategic attempt to restore serotonin levels back to normal. In many cases, this works.
However, those who use Molly and antidepressants at the same time put themselves at risk of serotonin syndrome. Because MDMA skyrockets the levels of serotonin and dopamine in the user’s brain, they can go into shock and have seizures.
Taking Molly While on Antidepressants
MDMA and antidepressants are a particularly dangerous cocktail for people who are prescribed to SSRIs. As Zoloft, Lexapro or Prozac and their byproducts accumulate in the user’s system over time, they work to regulate the amount of serotonin that can reach the brain. These medications work for depression because they prevent any influx of serotonin from rushing in.
When using MDMA, then, an individual on antidepressants might find that they don’t get high. They might take too much Molly in the attempt to feel its effects. This is where things can get dangerous, as the user can flood their brain with serotonin.
In the effort to feel the effects of Molly, some people end up taking too much. This can potentially lead to an overdose.
4. Some Cough Medications Don’t Mix with Depression Meds
One of the reasons why MAOIs are prescribed much less these days is that they have adverse reactions to a number of other common drugs. If an MAO inhibitor is mixed with drugs like Alka-Seltzer and Dayquil, for example, the user will find that they get extremely drowsy very quickly. This can be particularly dangerous if the user is driving or needs to operate heavy machinery.
SSRIs, as well, can have negative interactions with over-the-counter cough and cold medications. Sertraline and citalopram, for example, don’t mix with anti-inflammatory medications. While the combination may not kill you, mixing Lexapro, Prozac or Zoloft with aspirin can take a pretty serious toll on your liver. Because the liver is the place where SSRIs are processed, throwing anti-inflammatory drugs into the mix can cause it to work far harder than it should be. Over time, this can lead to liver damage, disease, and internal bleeding.
Do I Need to Stop Taking Cough Medicine if I’m on Antidepressants?
There are literally hundreds of cold and cough meds that can be purchased over the counter at any pharmacy. Some of them will respond adversely if used in conjunction with antidepressants. However, some medications are perfectly safe to take. If you’re prescribed to Prozac, Celexa or any other medication for depression, you can use this drug interactions checker to make sure that you’re in any danger.
Can You Skip a Dose to Use Drugs?
When it comes to recreational drug use, some people wonder if they can skip their antidepressant dose or stop taking it for a while if they want to get high. There are a few reasons why this presents a problem.
Firstly, SSRIs and other mood-stabilizers are able to take effect because they are used regularly over a fairly long period of time. This is why most doctors prescribe antidepressants for several months. Oftentimes, someone who struggles with depression won’t start to notice the effects of their prescription for at least a few weeks.
This timeframe will increase if the person uses other drugs or drinking alcohol. It will also increase if they skip dosages. Doing so is essentially erasing some of the work that your antidepressants have already done.
People often forget that antidepressants are intended to have long-lasting effects in the brain. Unlike cocaine, SSRIs and other depression meds have a relatively long lifespan in the body. This means that the drug and its byproducts live in your system for months, particularly if you take them on a regular basis.
Therefore, just because you skip one dose doesn’t mean you should start mixing other drugs with the antidepressants you’ve accumulated in your system.
Be Careful About Mixing Antidepressants with Other Drugs
Mixing antidepressants with alcohol, cocaine, Molly or other illegal drugs is never recommended. If you’re taking medication for depression, it is important that you leave the drug alone and don’t throw in any other substances that might prevent it from doing its job.
If you do need to take additional prescription or medications, make sure to consult a doctor or professional drug specialist first. They’ll be able to advise you on which drugs can be safely mixed with your antidepressant.