Polysubstance Use: Wellbutrin and Alcoholism
Wellbutrin and alcoholism are closely linked through the development of a mental illness: depression. Is it safe to drink alcohol while on a prescription medication like Wellbutrin? No. These two substances should be avoided. Both Wellbutrin and alcohol are depressant drugs that can significantly increase the risk of sedation and the risk of seizures.
Depression, or major depressive disorder, is a mood disorder. It is characterized by persistent feelings of sadness and loss of interest in things and activities once loved. Other symptoms of depression include empty mood, feeling hopeless or pessimistic, becoming easily irritated, feelings of guilt or worthlessness, decreased energy, difficulty concentrating and thoughts of suicide and death. It is a common mental health disorder affecting millions of people.
Wellbutrin is a prescription medication that can treat symptoms of major depressive disorder and seasonal depression. In some cases, it is used to help treat the depressive symptoms that people with alcohol use disorder often face. Depression is a common side effect of alcoholism and alcohol withdrawal.
According to the National Institute of Health, alcoholism or alcohol use disorder affects an estimated 15 million people in the US. A 2020 review found that those who were diagnosed with alcohol use disorder were at higher risk of developing depressive symptoms. Which then leads to the need to use antidepressant medications such as Wellbutrin. However, when the antidepressant is being used while drinking alcohol, it can counteract the effects of the medication.
What is Wellbutrin?
Wellbutrin is the brand name for the medication bupropion. It is a norepinephrine and dopamine reuptake inhibitor (NDRI) that blocks the reabsorption of norepinephrine and dopamine in the brain. This increases the levels of both neurochemicals in the brain, which can significantly influence mood, energy, and anxiety. Bupropion helps alleviate symptoms of depression and creates an overall mood-lifting effect.
Wellbutrin falls under its own category of antidepressant medications called an atypical antidepressant. It is technically classified as an aminoketone. It was first introduced in 1985. It is an FDA-approved medication prescribed for treating major depressive disorder, seasonal affective disorder (seasonal depression), as well as helping in smoking cessation. An estimated 80% of alcohol dependent people are smokers and 70% of those people are dependent on nicotine.
Common side effects of Wellbutrin
- Tremors
- Nausea
- Agitation
- Insomnia
- Dizziness
- Headache
- Dry mouth
- Weight gain or loss
- Constipation
- Blurred vision
- Seizures
On its own, one of the serious side effects of Wellbutrin is the risk of seizures. With the medication, seizures are dose-dependent. Meaning the higher the dose, the higher the risk of developing a seizure. Seizures occur when there are sudden abnormal electrical discharges in the brain. Although seizures are rare when on the antidepressant, most of the users who experience them are those who have underlying conditions that cause seizures or those who have an eating disorder and are taking a high dose of the medication.
The impact of Wellbutrin and Alcoholism
Both Wellbutrin and alcohol are central nervous system depressants. When taken together, they can cause dangerous side effects, including risks of seizures and reduce the effectiveness of the antidepressant.
- Confusion – It can disrupt the balance of brain activity
- Worsening depression
- Lack of coordination – It can affect motor skills
- Shaking and tremors – It can affect motor function
- Suicidal thoughts and behaviors
- Drowsiness and dizziness
- Headaches
- Nausea and vomiting
- Digestive issues
- Dry mouth
- Blackouts
- Blurred vision
- Paranoia
- Increased sedation
- Poor cognitive judgment – Higher risks of accidents
- Alcohol poisoning
- Restlessness
- Seizures
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The FDA warns that there are increased risks when using the antidepressant together with alcohol. When using them together, it may counteract the impact of the antidepressant medication. Because alcohol increases the risk of depression, the effectiveness of the antidepressant is significantly decreased, leaving you with very few options for treating that mental health illness.
The combination of the two can lead to a risk of developing a physical dependence on alcohol and alcoholism. Oftentimes, those who are experiencing depression self-medicate with alcohol on top of the medication they are already taking.
When interacting with alcohol, the combination of the two substances puts users at an even higher risk for developing seizures. Risks of seizures can be triggered by excessive alcohol use or by Wellbutrin. Seizures are more likely to occur in those with alcoholism. It can even occur in those who have no history of seizure conditions because the alcohol disrupts the normal electrical patterns in the brain, which increases seizure risk. Wellbutrin is known to have dose-dependent risks of seizures. The higher the dose, the more at risk you are for seizures.
Can Wellbutrin be used to treat Alcohol Withdrawal Symptoms?
Those diagnosed with alcoholism often go through alcohol withdrawal symptoms when they are detoxing from the drug. Alcohol attaches to and enhances the GABA chemical in the brain. This produces a slowdown in activity in the brain and body. When alcohol use has stopped, the brain is scrambling to rebalance itself and the brain is suddenly releasing large amounts of excitatory neurochemicals. This causes chaotic and sudden changes in brain chemistry balance, which leads to alcohol withdrawal symptoms.
Common symptoms of alcohol withdrawal include shaking, tremors, vomiting, confusion, disorientation, hallucinations and paranoia. Some of the most dangerous symptoms include seizures, severe depression and anxiety. Sometimes antidepressants like Wellbutrin can be prescribed to help treat the depressive and anxious symptoms triggered by alcohol withdrawal. This medication can be used as part of medication-assisted treatment (MAT).
Who is at most risk of dangerous side effects with Wellbutrin and Alcohol?
- Those who are heavy alcohol users – It can greatly impact those who are diagnosed with alcoholism because it puts them at high risk for seizures.
- Those who have seizures or are diagnosed with a seizure disorder – Both alcohol and Wellbutrin are substances that have a high risk of seizure on their own. When combined, your risks double.
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Treatment for Alcoholism and Substance Use Disorder
It is not recommended to drink while on Wellbutrin. This antidepressant mixed with alcohol is one of the most dangerous combinations because it can severely impair cognitive and motor functioning. They are both central nervous system depressants and can heighten the risks of seizures and alcohol poisoning. Wellbutrin can lower alcohol tolerance making it easier for a person to get drunk. Drinking alcohol can also counteract the benefits of the antidepressant medication. When taken together, it is also known as polysubstance abuse.
Professional behavioral health treatment programs such as Hotel California by the Sea, provide alcohol use disorder and substance use disorder treatment. Our program also specializes in co-occurring mental health disorders. We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based treatment methods that include CBT, DBT and EMDR therapy. Hotel California by the Sea is dedicated to helping our client reach their goal in sobriety and overcome their addiction.
References:
https://www.healthline.com/health/wellbutrin-and-alcohol
https://www.medicalnewstoday.com/articles/wellbutrin-and-alcohol
https://zinniahealth.com/substance-use/alcohol/with-wellbutrin
https://www.goodrx.com/bupropion/can-i-drink-alcohol-on-antidepressants-bupropion
https://alcoholawareness.org/alcoholism/detox/medications/bupropion
https://www.choosingtherapy.com/wellbutrin-and-alcohol
https://alcoholrehabhelp.org/interactions/wellbutrin/