Are there any studies on or knowledge of the physically harmful
side-effects side effects of mixing the SSRI paxil with alcohol? My
doctor assures me the only effects are psychological (i. e. that the
alcohol will work against the paxil's anti-depressant effects), but I
want to know if there are other known (esp physical) drug
interactions.

Hello sevenfoot,

Thank you for your question. Please do note the disclaimer below that
Google Answers is not a subsitute for professional help of any kind
and simply provides research for sources of information to answer your
question. I am not a doctor, but have found information that should be
of interest to you.

Other people seem to have asked the same questions and had the same
concerns. As most sites note, mixing alcohol and prescritption drugs
is seldom if ever a good idea, and some people have had adverse
physical effects to this combination of Paxil and alcohol.

Searching for [paxil +alcohol], I found the following information and
discussions for you:

BiologicalUnhappiness.com 
   
"Does Combining Paxil With Alcohol Damage The Brain?

QUESTION:

Dear Dr. Heller,

I am a 20-year-old college student, and I am on Paxil 10mg.  I don't
drink everyday, but I do drink.  Recently a friend of mine told me
that drinking while taking Paxil will damage my brain.  I take it for
social anxiety and I feel that it is working, but is it also hurting
my brain?  Please let me know.


ANSWER:

As far as I know, the combination of Paxil with alcohol doesn't damage
the brain any more than just taking alcohol by itself."

http://www.biologicalunhappiness.com/AskDoc/Paxil-alcohol-brain-damage-2001-Nov.htm

And, at the same site:

"What Is Alcohol Doing To My Paxil?

QUESTION:

Dear Dr. Heller,

Hello, I am 28, male, and have been taking Paxil for social anxiety
disorder for about 3 months and am now up to 40mg a day.  My doctor
has repeatedly warned me that drinking alcohol will cancel the effects
of Paxil.  I am realizing that the amount of alcohol I have been
drinking in the past and now (about 1 - 2 drinks everyday - average)
is due in large part because of my anxiety.  I am hoping that the
Paxil will make me want to drink less alcohol as it alleviates certain
fears, but I am worried that I won't reach this level because the drug
isn't working as it should - a kind of catch 22...

Thanks so much.

 
ANSWER:

Your physician is correct.  When you consume alcohol it temporarily
renders SSRI medications like Paxil useless.  This means your
underlying symptoms will get worse..."

http://www.biologicalunhappiness.com/AskDoc/alcohol_doing_to_Paxil.htm


At Med Help International

"...Hi, I need some help determining what I'm feeling here. I've been
on Paxil for about 3 and a half weeks now and the last week I have
done some serious drinking on a very constant basis. Yesterday I
stopped the drinkin but I felt racked by nerves and the panic attacks
came in horrible waves, causing me to throw up three different times.
All during the night I felt like I was crazy and I awoke all night
about every thirty or forty-five minutes. Another factor to take in to
affect is that I stopped paxil about 2 days before this awful episode
last night. Please help."

Answer:

"Paxil should not be combined with alcohol. It sounds like you are
having withdrawal symptoms from severe alcohol drinking. Alcohol
withdrawal can cause significant anxiety, nausea, vomiting, insomnia,
tremors, seizures etc. Paxil need to be tapered off slowly before
being stopped otherwise it would give side effects.I would recommend
that you consult your psychiatrist as soon as possible for an
evaluation."

http://www.medhelp.org/forums/mentalhealth/messages/30948a.html

And yet another at the same site:

"I  recently increased my dosage of Paxil from 20mg every 2 days to
20mg every day. I did this because 2 weeks ago I would start to shake
after every meal. I assumed it was because I was not taking enough
Paxil. At this point I increased the dosage . A week later the shaking
got worse acompanied with vomiting after meals.I would also start
sweating after eating, and could not sleep at night. My doctor told me
to stop taking Paxil altogether because that was causing the shaking,
not the anxiety.He explained that the seratonin levels in my brain
were too high. I am on my second day without the Paxil and the shaking
is still bad. I do consume about 6 beers a night and have done so for
about a year, which is the only thing I have found to help me sleep.

I need advice: do you think I should continue not taking the Paxil, or
do you think the alcohol is causing theese symptoms.

Answer:

In my opinion, it's not a good idea to be taking an antidepressant
when you are drinking heavily. Six beers a day is more than ANYONE
should drink. It's enough to develop physical dependence on alcohol,
and enough to lead to cirrhosis of the liver and other alcohol-related
medical problems..."

http://www.medhelp.org/forums/addiction/archive/237.html

PillJunction.com discusses Paxil and side effects:
http://www.pilljunction.com/paxil.asp

"...Alcohol intake should be limited because alcohol is a depressant
and in combination with Paxil® may increase drowsiness and fatigue...
"

psybersquare has another thread on Paxil and alcohol and one user
responds:
http://www.psybersquare.com/wwwboard/messagesmark/4747.shtml

"I have been taking Paxil for 5 + years, and drink at least 2 times a
week socially sometimes even in excess, I can tell you that you will
feel the effects of the alcohol more while taking Paxil but the major
difference is that a hangover is about 10 times worse than without
being on the Paxil. If you are going to drink I think it is fine, just
don't drive and be prepared for a doozie of a hangover!..."

And at a Harvard forum on panic disorders:
http://neuro-www.mgh.harvard.edu/forum_2/PanicDisordersF/2.26.9912.21AMPaxilandAlc.html

"My doctor tells me that alcohol can keep Paxil from working. However
I am in college and I am a social person. I find it very hard to go
out and to not drink at all. I have heard conflicting stories on the
effects of alcohol and Paxil. I've heard that a few drinks will not
hurt and I have also heard that it can wipe out the effects of Paxil.
I would appreciate some input on this, or just hear about your own
experience with Paxil.

Several people have replied to this question.

At Order Paxil-Zoloft-Prozac Online
http://www.order-paxil-zoloft-prozac-online.com/paxil/paxil-side-effects.html

"Paxil Side Effects/Usage Information 
Paxil ® is generally well tolerated by patients. As with many
medications however, there can be side effects. Some side effects
include decreased appetite, dry mouth, sweating, nausea, constipation,
sexual side effects in men and women, yawn, tremor or sleepiness,
nausea, drowsiness, sweating, a feeling of numbness, dizziness, dry
mouth, and insomnia. These side effects are generally mild and are
temporary...

...Paroxetine or Paxil should not be used with alcohol. Alcohol
consumption can amplify side effects and cause an increase in
drowsiness..."


Other threads on Paxil and Alcohol:

Healthboards.com
http://www.healthboards.com/ubb/Forum59/HTML/000019.html


Social Anxiety Message Board
http://pub9.ezboard.com/fsocialanxietysupportfrm29.showMessage?topicID=323.topic

"I have been on Paxil, and Buspar, for a few months now for GAD, OCD,
and panic disorder. But after weeks and weeks I wasn't getting any
better. But at the same time, I was drinking more, and more, and
MORE!!!! On day, durring a particularly bad hangover (watch out, these
meds can intesify a hangover like you've never felt before!!!) I
decided enough was enough and gave up the booze. That was a week ago,
and now I am a complete new person. The meds finally started working
and I have my life back. See, we all know that Paxil helps to keep
Seratonin were it needs to be, but what you might not know is one of
the many things Alcohol does to you body. That's right, it depleats it
of Seratonin, so you're taking a drug to regulate Seratonin, yet
drinking one that takes it away..."

About Depression - Paxil and Alcohol
http://forums.about.com/ab-depression/messages?msg=1448.1

"I am writing to you because my boyfriend was prescibed some Paxil for
Depression three weeks ago. It has made him feel much better, however
there are some problems when he drinks alcohol. He drinks only
socially and is normally a mild-mannered person when he has had a few.
Now he becomes nasty and destructive and a bit irresponsible.

As well as the above problem, the Paxil has caused him not to be able
to ejaculate, which is making him put off having sex...

There are 70 replies which can be reached by choosing Paxil and
Alcohol under Questions for the Group and then Keep Reading.


I trust my research has offered you experiences of others and comments
from medical professionals that will help answer your quesion.

If a link above should fail to work or anything require further
explanation, please do post a Request for Clarification and I will be
pleased to assist further.

Regards,

-=clouseau=-

Hi, sevenfoot!

I'm going to add my two cents' worth here, because Paxil is part of
day-to-day life in my household.  My wife was diagnosed five years ago
as depressed, and Paxil (while not a panacea) has certainly been
effective in her case.

Alcohol does negate the effect of Paxil.  That's well-established.  In
our experience, more than a couple of drinks (and perhaps even that,
if you don't drink regularly) will leave you without your Paxil safety
net.  We find that it takes until about the third day to feel "normal"
again (ie, before the meds regain their effectiveness).

If you have only recently been placed on Paxil (within the last
two-three months) I would strongly suggest that you let your body
finish adjusting to the medication before you resume social
drinking...if you choose to do that.

One further note: if you should require surgery while taking Paxil, be
sure that this is brought to the attention of the anesthetist.  We
learned the hard way that some general anesthetics will also counter
Paxil all too effectively.

Aside from this, and bearing in mind the usual disclaimers, I have
also been unable to find any physical issues relating to the
consumption of alcohol with Paxil.  As always, of course, moderation
is key.

Good luck!

-Chromedome