How Anxiety Medications and Co-Occurring Alcohol Abuse Create a Dangerous Combination

Benzodiazepines, such as Xanax, Ativan Valium, Klonopin, and Librium, are anxiolytic medications that are used to reduce symptoms of anxiety by having a sedative effect. They are the most commonly prescribed medications for anxiety disorders and are often the first line of pharmaceutical treatment prescribed. They work by acting on receptors for the inhibitory neurotransmitter GABA, making its transmission much more efficient. The increased efficiency of GABA results in the sedative effect, thus slowing and calming the central nervous system and effectively reducing the excitatory, panic-like symptoms of anxiety.

Alcohol acts in a similar way to GABA by mimicking, binding to its receptors, and producing the familiar sedative effect. This is the reason that anxiolytic medications are commonly used by physicians to wean patients off of alcohol and reduce symptoms of withdrawal. It also may help us understand why some people who take anxiolytics also develop an alcohol addiction. Both substances have an impact on the same neurotransmitter and have the similar physiological results. In fact, it is common for individuals to build up a tolerance to their anti-anxiety medication and then turn to alcohol as a form of self-medication, sometimes resulting in a co-occurring alcohol and benzodiazepine addiction.

When too much alcohol and anxiolytics are used in combination, however, the side effects can be dangerous. In fact, in 2010 benzodiazepines were implicated in 408,000 in emergency room visits across the United States, and 27% of these were patients who had mixed the medication with alcohol. Side effects of each substance compile together to produce impaired motor skills, memory loss or amnesia, dizziness, and dramatic mood swings. If a combined alcohol and anxiolytic overdose occurs it has the potential to result in a loss of consciousness, coma, or even death.

Anxiolytic medication isn’t the only type of medicine used to treat anxiety disorders. Antidepressants, like Prozac, Paxil, Celexa, and Zoloft, known as selective serotonin uptake inhibitors (SSRIs) are commonly prescribed to people suffering from anxiety. These drugs work differently than anxiolytics by making the brain’s supply of serotonin more available, thus elevating one’s mood.

Because they work differently in the brain, they also interact with alcohol differently. While the mechanisms aren’t entirely understood by medical professionals, it has been shown that mixing alcohol and SSRIs can lower your alcohol tolerance and cause memory loss. While it may be true that the combination can feel good in the short term, over time it can actually reduce the effectiveness of the medication and increase anxiety levels. Frequent mixing of alcohol and SSRIs can also cause people to develop side effects to the drug, such as insomnia, weight gain, and nausea.

While MOAs are not commonly described for anxiety, it is important to mention that combining these anti-depressive drugs with alcohol can be a life-threatening mix resulting in a dangerous spike in blood pressure which can lead to cardiovascular problems.

Of course, avoiding dangerous side effects isn’t the only reason to stay away from alcohol while receiving pharmaceutical treatment for anxiety. Because of the impact it can have on cognitive functioning and the potential memory loss that results, it can reduce the effectiveness of counseling or psychotherapy treatment. If you don’t remember the last appointment, it is certainly difficult to make progress.

Relationships can also suffer in a number of ways from alcohol use as a form of self-medication for anxiety. Your mood swings can difficult for your partner, friends, and family to bear, and can cause a great deal of worry and concern for those close to you. In some cases, it may even become too difficult for your loved ones to support you in the way you need them to.