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Bipolar Medications and Alcohol Interactions

Written by L. Anderson, PharmD on Nov 7, 2017.

Bipolar Disorder Medications and Alcohol

Bipolar disorder is a mental health disorder that involves extreme mood swings from emotional highs and excitement (called mania or hypomania) to emotional lows and hopelessness (such as depression). Bipolar disorder is also called manic-depression or bipolar affective disorder. The "mood swings" between mania and depression can be very sudden, and patients are at high risk for suicide. In bipolar disorder, patients are also at a higher risk for alcoholism, so drug interactions can be significant.

A variety of different medications can be used to treat bipolar disorder; these are best used along with psychological counseling (psychotherapy). Which medications are selected are based upon specific symptoms and previous treatments. Drug treatment may be selected from these classes:

  • Mood stabilizers or anti-seizure medications such as lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro) and lamotrigine (Lamictal).
  • Atypical antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel XR), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help. These may be used alone or with a mood stabilizer.
  • Antidepressants are usually prescribed along with a mood stabilizer or antipsychotic. The medication Symbyax combines the SSRI antidepressant fluoxetine and the antipsychotic olanzapine into one capsule.
  • Anti-anxiety medications such as benzodiazepines may be used, typically in the short-term only, to help with anxiety, agitation and improve sleep.

Alcohol drug interactions with bipolar disorder medications often result in an additive drowsy effect, which can be dangerous when driving or operating machinery. Alcohol and bipolar medication like certain anti-anxiety medications can result in depressed breathing and should never be mixed.

Because medications for bipolar disorder work in the central nervous system and affect chemicals in the brain, the addition of alcohol can worsen side effects like drowsiness, dizziness, memory impairment, confusion, poor judgement, and may also increase the risk for falls and injury. In general, it is best to avoid combined use of bipolar medication and alcohol. If you drink alcohol frequently, discuss this with your doctor. Be sure to review each medication for you are prescribed for alcohol interactions and discuss any concerns with your doctor and pharmacist.

Common Bipolar Disorder Medications*

Generic Name Common Brand Names
aripiprazole Abilify
asenapine Saphiris
cariprazine Vraylar
carbamazepine Tegretol, Equetro
clonazepam Klonopin
divalproex sodium Depakote
fluoxetine/olanzapine Symbyax
lamotrigine Lamictal
lithium Lithobid
lorazepam Ativan
lurasidone Latuda
olanzapine Zyprexa, Zyprexa Zydis, Zyprexa Relprevv
quetiapine Seroquel, Seroquel XR
risperidone Risperdal
ziprasidone Geodon

*Note: This is not a complete list; always check with your pharmacist for possible drug-alcohol interactions.

Types of Drug Interactions With Alcohol

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