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Alcohol and Antipsychotic Medication: Insane Mix Christina Dickey Beloit College, Beloit, Wisconsin Abstract Results According to one study, 40%-70% of those with bipolar disorder also had a substance abuse problem. Bipolar symptoms often worsen when alcohol is consumed. The alcohol interacts with the medication in a way that prevents it from working and can even elevate the symptoms of mania. Some people may not realize that alcohol is a depressant. Mixing antidepressants and alcohol can be dangerous and possibly fatal. My goal was to investigate the dangers of mixing anti-psychotics and drinking so that those who chose to combine the two can be informed about the serious, long-term risks to their mental and physical health. Studies show that alcohol prohibits antidepressants and antipsychotics from working. When the two are combined, there is a higher occurrence of psychotic episodes and more drastic symptoms of intoxication. People who take Lithium should not drink. With bipolar disorder the consequences of drinking are drastic and almost immediate. The alcohol changes the already unstable chemistry in the brain and can lead to black outs, manic episodes, and on the physical end, liver failure. Figure 1 shows that people with mental disorders are more likely to have a substance abuse problem. However, studies show that bipolar patients can recover from their alcoholism more easily then alcoholics without bipolar disorder, and with less chance of relapsing than most alcoholics, when treated with a combination of medication and therapy. Introduction With the development of modern psychology, more people have been diagnosed with bipolar disorder. The condition is caused by an imbalance in the brain and involves times of mania and depression, among other things. There are several types of bipolar disorder. Type I, the most severe, has the most drastic symptoms including mania that can last for a few weeks at a time.Type II usually involves hypomania and elevated self esteem. Cyclothymia causes hypomania and depression. Major depression, the kind of depression that will most likely benefit from treatment with medications, is a condition that lasts 2 weeks or more, interferes with a person's ability to carry out daily tasks and enjoy activities that previously brought pleasure. Depression is associated with abnormal functioning of the brain. An interaction between genetic tendency and life history appears to determine a person's chance of becoming depressed. Episodes of depression may be triggered by stress, difficult life events, side effects of medications, medication/substance withdrawal, or even viral infections that can affect the brain(1). Method I used peer reviewed literature, and online sources. References 1. http://www.nimh.nih.gov/publicat/medicate.cfm 2. http://images.google.com/imgres?imgurl=http://pubs.niaaa.nih.gov/publications/arh25-2/126135_files/image002.jpg&imgrefurl=http://pubs.niaaa.nih.gov/publications/arh25-2/126135.htm&h=340&w=450&sz=13&hl=en&start=6&tbnid=5YE75gpE888k7M:&tbnh=96&tbnw=127&prev=/images%3Fq%3Dalcohol %2Band%2Banti%2Bdepressants%2B%26gbv%3D2%26svnum%3D10%26hl%3Den%26sa%3DG 3. http://www.nelmh.net/downloads/ukppg/LITHIUM.PDF 4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7375485&dopt=Abstract 5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4006376&dopt=Abstract for MEDLINE] 6. http://cat.inist.fr/?aModele=afficheN&cpsidt=3634530 Résumé / Abstract 7.http://books.google.com/books?hl=en&lr=&id=qlDFD0SLXlcC&oi=fnd&pg=PA1&sig=93zzqwTJobOjCOFDCvIkdNbj4T4&dq=antipsy chotics+and+alcohol+use+#PPP10,M1 8. http://www.nimh.nih.gov/publicat/medicate.cfm 9. http://ajp.psychiatryonline.org/cgi/content/full/156/10/1506/F1 Discussion Figure 1: Comorbid Mood Disorders* and Substance Abuse Any Substance Abuse or Dependence(%) Alcohol Dependence (%) Alcohol Abuse (%) Any Mood Disorder 32.0 4.9 6.9 Any Bipolar Disorder 56.1 27.6 16.1 Bipolar I 60.7 31.5 14.7 Bipolar II 48.1 20.8 18.4 Unipolar Depression 27.2 11.6 5.0 NOTES: *Mood disorders include depression and bipolar disorder. Bipolar disorder, or manic depression, is characterized by extreme mood swings. Bipolar I disorder is the most severe bipolar disorder. Bipolar II disorder is less severe. Unipolar depression is depression without manic episodes. SOURCE: The Epidemiologic Catchment Area study (Regier et al. 1990). Figure 1 shows the ECA study (Regier et al. 1990). This study showed that 60.7% of people who have Bipolar I disorder had a lifetime diagnosis of substance abuse, (e.g. alcohol, drugs). There were 48.1% of people with Bipolar II disorder who had a substance use disorder while 39.2% had an alcohol abuse problem. It should be noted that alcohol dependence was found to be more likely with Bipolar disorder than with alcohol abuse. There is very little research into the effects of antidepressants when combined with alcohol. More research needs to be done on the dangers of combining the two. Conclusion With the congruence of substance abuse and Bipolar disorder, those with bipolar disorder should be cautious when it comes to substance use. Alcohol can increase the rapid cycling of moods and enhance the mania associated with bipolar disorder.