Alcohol Cravings Induced via Increased Serotonin

[historyteach]

I found this very important article and knew I had to share it here. Many of us have dual diagnoses, with alcoholism and mental health issues. Yet, if we are given an SSRI for the MH issue, which increases serotonin, it can actually backfire, and cause a relapse with the drinking!

Here's the article.

Alcohol Cravings Induced via Increased Serotonin
by Ann Blake Tracy, Director, ICFDA

There is an alarming connection between alcoholism and the various prescription drugs that increase serotonin. The most popular of those drugs are: PROZAC, ZOLOFT, PAXIL, LUVOX, SERZONE, EFFEXOR, ANAFRANIL, and the new diet pills, FEN-PHEN and REDUX. For seven years numerous reports have been made by reformed alcoholics (some for 15 years and longer) who are being "driven" to alcohol again after being prescribed one of these drugs. And many other patients who had no previous history of alcoholism have continued to report an "overwhelming compulsion" to drink while using these drugs.

(A few personal accounts: #1 A young woman, a recovering alcoholic, reported that during the eight month period she had been using Prozac she found it necessary to attend AA meetings every day in order to fight off the strong compulsions to begin drinking again. #2 In the Southeastern United States a middle aged psychologist, also a recovering alcoholic, after being prescribed Prozac, found herself needing to attend AA meetings morning, noon, and night to keep from destroying the sobriety she had achieved. #3 A young father, who was Mormon and had never before in his life used alcohol, found himself drinking Ever Clear and exhibiting bizarre as well as violent behavior, after being prescribed Prozac and Ritalin. #4 A young mother who had never used alcohol before began drinking large amounts within weeks of being prescribed Prozac and quickly found herself committed to a mental institution due to the psychotic behavior that resulted. Added to her Prozac prescription were anti-psychotic meds and electric shock treatments. She then began to experience seizures and was started on anti-seizure meds. #5 A concerned neighbor reported her friend was drinking straight Vodka on a regular basis after being prescribed Zoloft. #6 A daughter reported her father, sober for 15 years, began drinking again on Prozac. The consistant report from these patients has been an "overwhelming craving or compulsion" for alcohol.)

For some time we did not have specific medical documentation to help us understand why this was happening. Could it be that Prozac, Zoloft, Paxil, etc., being mood altering substances, were removing the inhibitions that individuals had placed upon themselves to stop their additions? But beyond this mood altering effect of Prozac, etc., there seemed to be a physiological cause for this alcoholic obsession as well. There were reports of people who rarely drank before Prozac, etc., consuming excessive amounts of alcohol after starting usage of these various drugs. For example we have the case of a young newly wed in Southern Utah who was given Prozac for a hormonal imbalance. Before that time she would have two or three social drinks a year, yet soon after being prescribed Prozac she began bringing alcohol home by the case. Many similar reports followed.

Could it be that because these drugs have such a strong adverse effect upon the pancreas [Manufacturer's warnings include such side effects as hypoglycemia, diabetes and pancreatitis.]they are producing a potent disruption in the body's blood sugar balance? This would in turn cause a "craving" for alcohol as the body reaches out for a "quick fix" to raise the blood sugar level thus triggering a vicious self-perpetuating cycle as the alcohol pushes the blood sugar level even lower after the brief high it produces. This means that those suffering a tendency toward alcoholism or any other blood sugar disorder would suffer the most disastrous repercussions of Prozac, etc., (including psychosis, suicidal ideation and violence) much faster than most. Patient reports support this conclusion.

In November of 1994 Yale published a study that gave us one answer to the alcohol cravings associated with these drugs. The study demonstrated that an increase in brain levels of either of two neurotransmitters (brain hormones), serotonin or noradrenalin, produces: #1 a craving for alcohol, #2 anger, #3 anxiety. They found this to be especially true for those who have a history of alcoholism. All of the drugs listed above are designed in one way or another to increase serotonin which in turn also increases noradrenalin. Anyone who has a history of alcoholism should heed the warning contained in these reports. And anyone who has developed a problem with alcoholism while using these drugs deserves answers as to why they have experienced such an overwhelming compulsion to drink.

America already has an estimated 10 -15 million alcoholics. To increase that number with a reaction from prescription drugs which causes a compulsion to drink is a tragedy! What a sad state of affairs that drugs which are actually being promoted as a treatment for alcoholism have the potential to create alcohol craving behavior. This is not only frightening, but absurd. It is heart-rending to listen to those who have had years of sobriety destroyed almost overnight or those who have never touched alcohol before Prozac, yet began drinking compulsively due to a medication prescribed by doctors unfamiliar with this connection. By chemically inducing an overwhelming urge to drink this effect also causes patients to mix alcohol with these powerful drugs. When alcohol and drugs are combined, one can compound the effects of the other so the resulting impairment is far worse than if the two were taken separately...even small amounts, mixed with some medicines, will deaden your senses or change your perceptions which can lead to psychotic behavior, seizures, etc. Those in this situation need to be made aware that they are not alone, and that this is a common report which is now substantiated by medical documentation. They also need to understand that it is possible to very gradually withdraw from these drugs and overcome these adverse drug reactions.


SORUCE:- References for this material: Krystal JH, Webb; E, Cooney N.; et al., "Specificity of Ethanol-like Effects Elicited in Serotonergic and Noradrenergic Mechanisms," ARCHIVES OF GENERAL PSYCHIATRY, Vol. 51, Issue 11, pgs 898-911. (This is the Yale study mentioned above.); In a study conducted by Liisa Ahtee and Kalervo Eriksson (Physiology and Behavior, Vol. 8, pp. 123-126, 1972) rats which preferred alcohol had 15-20% higher concentrations of serotonin in the brain.

If you've had problems with relapsing, and you've been on SSRI's perhaps it's time to reconsider the use of the SSRI! Maybe you should print this article out and bring it to your doctor. For a very long time, SSRI's have been considered "safe." This article brings that assumption into question, at least for those of us who have issues with drinking problems.

Shalom!

[Trying.]

Oh thats just an excuse. One could say being depressed would make one feel they want to self medicate..one could say smoking a cigarette creates the feeling one wants to enjoy a drink with the cigarette....

[Done_With_It]

Thanks Teach! I personally do not believe everything is "just an excuse".
Especially when it comes to others, since I do not know their mind or body. It's been my experience that meds do make a huge difference, so I can see how it could go this way as well!

I am one to keep an Open Mind about everything, or I try! Thanks!

Great article!


:ghug

[Conez]

very interesting... would like to follow the thoughts on this.
My Dr prescribed SSRI's on day5 detox(due to intense upset/lack of coping)... stating anxiety/depression side effect would intensify for a few wks n then hopefully i will start to notice a difference.
as trying pointed out ...one could say being depressed would make one feel they want to self medicate.... well i do!! with a mindnumbing coldie (esp in early intense SE of SSRI meds)
now i chose to not medicate anymore with alcohol... so my DR gives me an SSRI... is this the answer> time will tell...
very interested in printing this lil piece by Ann Blake Tracy an gettin my Dr's thoughts... esp duration of treatment... thinkin short term is meant to help not hinder absintance.... with the thought the treatment with SSRI's are complemented with futher MH support.... to assit in complete recovery.
Altho not talkin about my Dr... these ones that hand out pills with no other methods of intervention.... would be the part of the reason makin SSRI's another relapse statistic

[nandm]

I found the article quite interesting. It made me wonder if the people who suddenly started drinking after going on the SSRI's were predisposed to alcoholism in the first place. My second thought was the two that had to attend AA to keep away the cravings were no different than many alcoholics who do not take SSRI's. Before I started the SSRI's I needed AA to stop drinking and teach me how to live without the alcohol. It also relieved my obsession to drink when I did the steps. What is different for me is in sobriety I have been on Prozac, Celexa, Lexapro, and Cymbalta. None of which affected me in the ways described in the article. That would lead me to believe that when an SSRI is prescribed the MD might need to consider the family history and if there is one of alcoholism, warn the patient that they may need to start a program of recovery such as AA if they develop alcohol cravings. I may not have developed the cravings with the meds because I was currently working the steps and working a program of recovery.

[historyteach]

Welcome to the Mental Health forum, Trying and Conez!
You'll find a very supportive forum here.

I, too, wouldn't be so quick to judge others. Especially since the studies are done by such repudible sources as Yale! And the fact that people who never had alcohol problems suddenly developed them AFTER being prescribed SSRIs! Those are two pretty convincing pieces of data to just dismiss with an *opinion.*

Like Done With It, I would prefer an open mind. Knowledge is power. If it doesn't effect you, fine; nothing lost. If it *does* effect you, then maybe bringing this article to the attention of your prescriber is an important part of your recovery!

Conez, I agree, therapy with medication is best. I'm glad your doc is expecting that of you.

Nandm, family history should always be a part of any medicine being handed out. But, I like the idea you bring up about the program being a possible reason why you didn't have any problem too. Or perhaps you just wouldn't have had one to begin with? Who knows? I'm just glad you didn't!

Shalom!

[TiredMama]

Open mind is the key here. Everyone is different and I believe Teach was posting this just for that reason.

Thanks for posting. I thought the article was quite interesting.

[stone]

I take SSRIs and am an alkie so this is interesting to me. Thanks Teach. I wonder if there are more studies on this.

BTW, TiredMama, I love that pic! No Rain by Blind Melon is one of my favourite songs.

[pedagogue]

Originally Posted by historyteach

I, too, wouldn't be so quick to judge others. Especially since the studies are done by such repudible sources as Yale! And the fact that people who never had alcohol problems suddenly developed them AFTER being prescribed SSRIs! Those are two pretty convincing pieces of data to just dismiss with an *opinion.*

Interpreting research data can definitely be tricky, and it is important to take things as they come. The physiology is generally on target (SSRIs raise the levels of available 5HT, which can also effect noradrenalin, which can effect a number of things), but I don't believe they are causal (the use of SSRI--> causes more cravings for everyone.....there are too many other factors).

I think a complicating factor is that a typical SSRI takes 5-7+ weeks to work, so in the interim the person isn't getting the effect of the medication, and is left to cope via other methods, which may include alcohol use/abuse.

SSRIs also effect other neurotransmitters, which can have an effect on this stuff too. Unfortunately there are so many moving parts science hasn't yet sorted it all out.

I think the take away is that everyone needs to be aware that meds need to be used carefully and with a lot of communication with their prescribers. SSRIs are popular because they are relatively safe to use (less abuse potential than other meds), and there are generally well tolerated by people (less severe side effects). Of course, one size does not fit all, which is why a good prescriber is worth his or her weight in gold.

[stone]

Yea, Pedagogue, that's why I wondered if there was more research too. A few anecdotal accounts and one or two studies doesn't count for much really.

[stone]

New generation anti-depressants have little clinical benefit for most patients, research suggests.

A University of Hull team concluded the drugs actively help only a small group of the most severely depressed.

Marjorie Wallace, head of the mental health charity Sane, said that if these results were confirmed they could be "very disturbing".

But the makers of Prozac and Seroxat, two of the commonest anti-depressants, said they disagreed with the findings.

A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".


And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".


There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients
Professor Irving Kirsch
University of Hull


Alan Johnson, the Health Secretary, has announced that 3,600 therapists are to be trained during the next three years in England to increase patient access to talking therapies, which ministers see as a better alternative to drugs.

Patients are strongly advised not to stop taking their medication without first consulting a doctor.

The researchers accept many people believe the drugs do work for them, but argue that could be a placebo effect - people feel better simply because they are taking a medication which they think will help them.

In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.

They reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.

They focused on drugs which work by increasing levels of the mood controlling chemical serotonin in the brain.

These included fluoxetine (Prozac) and paroxetine (Seroxat), from the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), alongside another similar drug called venlafaxine (Efexor) - all commonly prescribed in the UK.

The number of prescriptions for anti-depressants hit a record high of more than 31 million in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.

There were 16.2m prescriptions for SSRIs alone.

The researchers found that the drugs did have a positive impact on people with mild depression - but the effect was no bigger than that achieved by giving patients a sugar-coated "dummy" pill.

People with severe symptoms appeared to gain more clear-cut benefit - but this might be more down to the fact that they were less likely to respond to the placebo pill, rather than to respond positively to the drugs.


When used correctly and appropriately anti-depressant therapy saves lives

Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.

"This means that depressed people can improve without chemical treatments.

"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."

Professor Kirsch said the findings called into question the current system of reporting drug trials.

Reviewing guidance

Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.


These medicines have been licensed by a number of regulatory authorities around the world, who looking at all the evidence, have determined that they do work better than placebo
Dr Richard Tiner
Association of the British Pharmaceutical Industry



He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.

He called for drug companies to be forced to publish all their data.

The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.

Marjorie Wallace of Sane commented: "If these results were upheld in further studies, they would be very disturbing.

"The newer anti-depressants were the great hope for the future.... These findings could remove what has been seen as a vital choice for thousands in treating what can be a life-threatening condition."

Dr Andrew McCulloch, of the Mental Health Foundation, said: "We have become vastly over-reliant on antidepressants when there is a range of alternatives.

"Talking therapies, exercise referral and other treatments are effective for depression.

"It is a problem that needs a variety of approaches matched to the individual patient."

Dr Richard Tiner, of the Association of the British Pharmaceutical Industry, said there was no doubt that there was a "considerable placebo effect" from anti-depressants when treating people with mild to moderate symptoms.

But he said no medicine would get a licence without demonstrating it was better than a placebo.

Dr Tiner said: "These medicines have been licensed by a number of regulatory authorities around the world, who looking at all the evidence, have determined that they do work better than placebo."


BBC NEWS | Health | Anti-depressants' 'little effect'

[stone]

The article didnt copy and paste very well, check the source for a better version.



This is the important thing

In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.

They reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.

It isnt just one study it is a review of 47 studies, the drug companies seem to have chosen the studies that backed up their claims and avoided (supressed?) studies that disagreed with their view.

A review of 47 studies that states that there is no statistically significant difference between SSRIs and a placebo?

[TiredMama]

Originally Posted by stone

I take SSRIs and am an alkie so this is interesting to me. Thanks Teach. I wonder if there are more studies on this.

BTW, TiredMama, I love that pic! No Rain by Blind Melon is one of my favourite songs.

Thanks. I love the LOL cats and that song as well.

[pedagogue]

Originally Posted by stone

A review of 47 studies that states that there is no statistically significant difference between SSRIs and a placebo?

There are differences, but most have been show to be effective (against placebo)....but the devil is in the details, as all of the studies have different benchmarks, lengths, and design parameters. Typically a clinical response is a reduction of 50% of symptoms, so a person who is severely depressed isn't going to be 'symptom free', but they are going to show an improvement. How long of an improvement....who knows, because most studies are short-term because of cost, availability of people, etc.

One of the big challenges of research (particularly company research) is how/what they compare....as they know (some/most) of the weaknesses of their meds. For instance, they may do a study comparing their med against another medication in regard to how quickly they can achieve a response. They can show theirs works quicker, but does it work better? Last longer? Fewer side effects? So any data needs to be evaluated very carefully.

So in many cases we are only gathering part of the story. The best way to handle the research is with a big grain of salt. Some of the best performing medications....have been around a long time, but they aren't talked about as much because companies can't make money off of a generic. Obviously they aren't perfect, but neither are the 'new' meds. There is no easy answers, though the research does give us an idea of some of the things out there.

In regard to this issue, I think it is important to realize that the med (even if it does what it is suppose to do), can still have some things to watch out for. It isn't a magic bullet, but a lot of the research has shown that treatment of various different things can be better when Med + Talk therapy is used.

It is good that people look up info about different things, because if nothing else it offers an opportunity to talk about things with your doc, but be aware that just because a study found something.....doesn't mean it will generalize to a particular person. In the end, it is better to have more information and have to sort through it, as compared to not enough and not know if you are missing anything.

[historyteach]

Ped;

...but I don't believe they are causal (the use of SSRI--> causes more cravings for everyone.....there are too many other factors).

While I totally agree that there can be many other factors involved,
*Nowhere* did this study say that it causes cravings for "everyone."
That's a vast overstatement of the research posted above.

Stone,
Thanks for the article. I was just reading something else on this today, about the drug companies ignoring studies that don't support their desired findings.

Also, Michael Moore has a piece on a site that I found today. He calls the hidding of the evidence against the SSRIs "criminal." Now, I know Moore can be strong in his language, but, if they are indeed hiding evidence that is counter to their claims, and I am taking something under false pretenses, I am being treated fraudulently. I deserve to KNOW the facts in order to make a knowledgable choice.
Here it is:
Drug Awareness.Org - Home

Please understand, I am NOT saying to drop your meds.
But, I do intend to talk to my pdoc about this when I see her next week.
Knowledge *is* power. And it *is* our lives.

I've already been messed over once due to medications. Most of you already know this. I will *not* allow it to happen again. I want to know what it is I'm ingesting. I have a right to know what the studies *really* say. I don't want to be lied to by the pharmicutical companies so they can make more millions off my suffering.

I want to; I demand to make an informed choice.
It's *my* life!
And I will be talking to my pdoc about this when I see her next week!

Shalom!

[pedagogue]

historyteach, you are quite correct in burying research. There has been a scary history of research getting buried because it was unfavorable....some of it has been caught, others not. The gov't is trying to force companies to be more forthcoming. Also, some of the research can be skewed (using an optimal dose of a particular med, but under-dosing a competitive med and calling it a 'comparable dose').

Knowledge is definitely power, though make sure to take everything with a grain of salt, as it is a tricky business out there (pharma research).

[Done_With_It]

Originally Posted by historyteach

Ped;

While I totally agree that there can be many other factors involved,
*Nowhere* did this study say that it causes cravings for "everyone."
That's a vast overstatement of the research posted above.

Stone,
Thanks for the article. I was just reading something else on this today, about the drug companies ignoring studies that don't support their desired findings.

Also, Michael Moore has a piece on a site that I found today. He calls the hidding of the evidence against the SSRIs "criminal." Now, I know Moore can be strong in his language, but, if they are indeed hiding evidence that is counter to their claims, and I am taking something under false pretenses, I am being treated fraudulently. I deserve to KNOW the facts in order to make a knowledgable choice.
Here it is:
Drug Awareness.Org - Home

Please understand, I am NOT saying to drop your meds.
But, I do intend to talk to my pdoc about this when I see her next week.
Knowledge *is* power. And it *is* our lives.

I've already been messed over once due to medications. Most of you already know this. I will *not* allow it to happen again. I want to know what it is I'm ingesting. I have a right to know what the studies *really* say. I don't want to be lied to by the pharmicutical companies so they can make more millions off my suffering.

I want to; I demand to make an informed choice.
It's *my* life!
And I will be talking to my pdoc about this when I see her next week!

Shalom!

Teach I was on that site today. Very Very Interesting stuff on there.

I believe a lot of what they are saying, and I have heard a lot of it before.
I met a doctor a few weeks ago, who heard about "My Story", She asked me if I would ever consider "Medical Marj." for some of the things we were talking about, it was all off the record, and it was Totally Just a Question, it came up because she was "Explaining" Zyprexa to me.

Her point was that for as bad as a rap as it gets the same people are handing out Mega Doses of Drugs, Drugs, Drugs, and "Do I" "REALLY" know what I am putting into my body, and to just be careful.
A doctor will give me a bottle of Clonopin, Vicodin, etc. but frown on a natural plant.
I am not saying this to get into a MM debate, as I won't even discuss it on here, Just what she said and how she was explaining the effects and some of the meds are very similar to what that site was saying.

I saw the thing about the Mothers being subscribed meds for being pregeant. Scary. It all scares me.

My 'last' doctor asked me how the Paxil worked, I said it didn't.
He said, YEA I FIGURED AS MUCH, THAT'S EXACTLY WHAT I THOUGHT..
I was like so you gave me a bottle ? FOR????

[TiredMama]

I saw the thing about the Mothers being subscribed meds for being pregeant. Scary. It all scares me.

I had to really be careful with this pregnancy because my doc was going to give me percocet on a couple of occasions.

[Done_With_It]

Originally Posted by TiredMama

I had to really be careful with this pregnancy because my doc was going to give me percocet on a couple of occasions.

That is just crazy to me.

Did you see this?

Care2 : The Petition Site : STOP THE DANGEROUS A

YouTube - One Example of Why We MUST Stop the MOTHERS Act


Scary Stuff

I'm still not saying anti's are bad, for me they seem to work well, But
One of the thing that frustrates me so much is one of the reasons I
quit doing meth was because I hated being so dependent on my dealer,
but now trying to be healthy it's the same thing.

The doctors 'say' you have a say in your health care, but all to often if you
do not do as 'they say', then you are just as screwed as if you were dealing with your dealer.

I hate being dependent on anything and anyone..

[historyteach]

Pretty powerful, Miss Done!
I signed!

Shalom!

[barb dwyer]

Stone wrote-

No Rain by Blind Melon is one of my favourite songs.

mine TOO!

HistoryTeach wrote -

Also, Michael Moore has a piece on a site that I found today. He calls the hidding of the evidence against the SSRIs "criminal." Now, I know Moore can be strong in his language, but, if they are indeed hiding evidence that is counter to their claims, and I am taking something under false pretenses, I am being treated fraudulently. I deserve to KNOW the facts in order to make a knowledgable choice.

The Federal Government thinks you do, too.
The PROBLEM has been,
when introducing litigation in matters like drug research/findings supression - also to include Tobacco/Nicotine lawsuits as well - THEY have far more $$$ for the 'paperwork burial'' filings that litigators do so well. The large corps have their OWN lawyers - and when they know they're wrong that's how they eliminate the opposition.

I thought this was quite interesting, in fact.

[TiredMama]

Originally Posted by Done-With-It

That is just crazy to me.

Did you see this?

Care2 : The Petition Site : STOP THE DANGEROUS A

YouTube - One Example of Why We MUST Stop the MOTHERS Act


Scary Stuff

I'm still not saying anti's are bad, for me they seem to work well, But
One of the thing that frustrates me so much is one of the reasons I
quit doing meth was because I hated being so dependent on my dealer,
but now trying to be healthy it's the same thing.

The doctors 'say' you have a say in your health care, but all to often if you
do not do as 'they say', then you are just as screwed as if you were dealing with your dealer.

I hate being dependent on anything and anyone..

I took anti's with my first pregnancy and with this one as well. Actually, with this one I didn't take them the entire pregnancy but it was getting really bad for me around the 6th month. My first born came out 12 pounds and healthy, with minimum w/d's from the anti. I hope the same for this one.