Could alcohol be affecting how sertraline works and my mood?

[WellINeverKnewThat1]

NC for this post.

I have been on sertraline for over 5.5 years. I went up to 100mg last year. I’ve been feeling pretty low recently which has been exacerbated by a relationship break-up and I’ve been thinking about giving up alcohol just to see how I feel etc.

I have literally just discovered that the NHS doesn’t recommend that you drink whilst taking this drug?!?! I honestly had no clue.

I do think I have drifted into drinking too much. I don’t feel dependent on it by any means but for example this week:

Monday - 2 x 200ml bottles of prosecco (with a friend)
Tuesday - 2 x medium glasses of wine (at home alone)
Wednesday - I met some friends so had just shy of a bottle of Prosecco
Thursday - a glass of wine I think (at home alone)
Friday - went out, had a medium glass of wine and 3 cocktails
Yesterday - a glass of prosecco
Today - 3 x glasses of Prosecco in the pub with a friend and a glass of wine at home

Now I’ve written it out, that’s actually quite a lot isn’t it? And could this be a reason why I am feeling pretty shit most of the time?

If you ingest a depressant (such as alcohol) at the same time as an antidepressant (sertraline) it kind of cancels out the therapeutic benefit of the medication. It also potentially increases the risk of side effects e.g. nausea, drowsiness etc.
separately to the medication, regular/daily drinking is not advisable for health reasons.
NHS suggested limits whether you agree with them or not are 14 per week.

This amount of alcohol would have me floored (but i do work full time and have a 3 and 12 yr old). I have a drink on a friday and saturday night usually, but i am starting to notice it affecting my sleep. Im 41 though so i maybe thats expected as i get older. Could it be affecting your sleep which makes you feel shit?

Yes I agree, it’s probably far too much and not doing me any good mentally or physically.

I am 33. I do find myself waking up regularly in the night I have to say.

It feels like most of your drinking is in your socialising, you went out 4 times in the week, does the socialising not make you feel good? I’d try to knock it on the head when home. Give yourself a break.

You should receive a patient information leaflet in every box and I have just checked the guidance online - the advice is to avoid alcohol.
separately to this, you should read the leaflet in case there are other issues you need to be aware of - contraindications, other meds etc etc.
if you are going to drink regularly please make the prescriber aware

I'm surprised the medic who prescribed the sertraline didn't tell you not to drink alcohol while taking the tablets. I'm pretty sure the patient leaflet tells you to avoid alcohol, as it is a depressant.

I genuinely cannot remember being told this. It was a while ago that I started it, but I increased my dosage last year and don’t remember being asked about my alcohol consumption then. I feel like the penny has just dropped to be honest

My psychiatrist said it was fine to drink in moderation when taking sertraline but you’re not really drinking in moderation so it is probably not helping at all. That amount of alcohol is not good for you, whether you’re taking sertraline or not.

I didn’t realise how many units are in Prosecco…

could you try not drinking for a couple of weeks and see if you start to feel differently? I also take Setraline and I have weeks of not drinking at all and feel 100 times better after a few days. Alcohol affects the quality of sleep, so you feel crap the next day, and it becomes a bit of a vicious circle. I do drink, but try to keep it to only 1 or 2 days a week, and 2/3 glasses of wine at most. Drinking every day doesn’t give your body time to recover, and will impact the effectiveness of the Sertraline.

Yes. Alcohol is known to make people feel worse physically and mentally when they drink excessively. Add in antidepressants and you’ll likely feel much better without alcohol.

I find there are two levels of don't drink with this drug type situations. The first is 'don't drink with this drug, you will projectile vomit or knacker your liver' type advice. The second is 'we don't really recommend you drink with this drug' . Sertraline falls into the second category. My guess is that GPs know a lot of patients would refuse antidepressants altogether if they were told they couldn't drink with them, such is the alcohol culture in the UK. So they are cautious with their advice as they do want the patient to accept the meds. I stopped drinking due to a drug that falls more into the first category. But since then I've become much more aware of our culture around alcohol and how pervasive it is. Including on TV dramas as well as in real life. It's strange to watch from the outside actually. But I am certain you will feel better, whether you cut down or stop totally.

Yes, I’ve been wanting to cut down anyway but this is a real eye opener!

yes, you shouldn’t be drinking any acohol while on antidepressants it’s a depressant. Don’t need to cut down you need to go tee-total.

I take Sertraline. My GP knows that I drink alcohol, and has never said that the Sertraline is a reason not to drink. But she has (weakly) recommended cutting out alcohol because of its negative effects on anxiety and depression

I don't think that the combo of alcohol and Sertraline is dangerous. I guess the problem is more that, if you are new to the drug and feeling drowsy etc., that effect will be potentiated by the alcohol and you may find yourself being drunker than you anticipated and therefore vulnerable.

However, it is a kind-of self-sabotaging combination, since its negative effects on anxiety and depression are probably as powerful as the positive effects of the medication.

Having said that, though, I tried six weeks alcohol-free a couple of months ago and felt no better at all, physically or mentally .

So I am back on the booze. I do feel that I should give up, though.

On a separate point, 100mg is only half the maximum dose, I think. Might there be scope for trying a two-pronged assault on your mood: Ditching alcohol and upping the dose?

Another way forward might be just to stop drinking at home, and keep it for your social life.

I avoid alcohol because of the very reasons stated. Stops sertraline working properly

Honestly I just feel like my whole life needs a huge overhaul!

I was drinking (couple of glasses in the evening) and also taking medication that dries your mouth - didn’t realise combined with the alcohol my body was seriously dehydrated. Terrible brain fog

Well that’s another problem. I barely drink any water. Yesterday - perhaps a small glass all day? The rest was Diet Coke / a cup of tea.

You know what you need to do OP, up the water, ditch the alcohol, get outside in the fresh air and make a new routine. Stick to it for a few weeks and see if you notice improvement. If you don’t, back to the GP for medication uplift, but seriously try that stuff first.

That sounds potentially overwhelming but kudos to you for recognising changes need to be made.

Drinking less would be a good place to start.

That’s a lot of alcohol even without considering the sertraline. I took it years ago (now on paroxetine) and could have a drink with no ill-effects but I’m talking the odd beer or mixer, not multiple glasses of wine a night.

Drinking now and again on sertraline is fine.

Drinking every day with it will make it less effective.

There’s a fairly straightforward way to find out… 😊
I would be tripple whammied with that amount of socialising, the alcohol and the underlying reason you take sertraline.
Add in the hormonal fluctuations women deal with, and that’s a lot of stuff to manage.

Have a quiet week, minimal alcohol, a bit less socialising, see what happens.

Thank you all.

The previous Thursday night I went out and had 4 cocktails, half a bottle of wine, 2x medium glasses of wine. On a weeknight. That’s terrible. No wonder I feel like shit!