Health QuestionsCategory: TreatmentsCipramil interactions?
KMMH asked 3 years ago

My flatmate and I are studying biology, and in a lecture he heard about manic depression, decided that was him and got perscribed Cipramil 20mg. Since he’s been taking it, he takes it erraticaly (often waiting for an audience to pull the pills out of his bag and show them off), and technically binge drinks on them (2-3 bottles of wine one day, a few hours in a pub another day). He’s complained that he’s got a constant cough and is now taking paracetamol and cough bottles and herbal tinctures etc etc often. He’ll also sleep in until around 12:00 when he wouldn’t normally before. I haven’t noticed any great change in his “mood”, neither has anyone else close to him.
 I was wondering several things.  I know mixing alcohol and medications is the wrong thing to do, but what can actually happen when you mix an SSRI and alcohol? What about mixing it with paracetamol and cough bottles on a regular basis? And are there any medical/pharmaceutical text books I could find information in?
 Of course it’s not my medication and therefore not my choice, but what my friend is doing can’t be good for him, not to mention that other friends with experience of anti-depressant medication find it demeaning that he takes these drugs aparantly so flippantly.

3 Answers
adieuolivaw answered 3 years ago

Re: Cipramil interactions?
Hi, KMMH!
 
About alcohol and SSRIs
Quote:

CRAZY MEDS: You know the drill, you shouldn’t drink when on meds, but come on. Just because I’ve given up booze doesn’t mean I’m going to get all preachy on you. Basically with the newer antidepressants, booze isn’t that big a deal.

HOWEVER…
About alcohol and folic acid:  Alcohol creates folic acid deficiency, which results in too-high levels of homocysteine, which weakens the immune system, which can cause infections and immune diseases. Lack of folate is the most common vitamin deficiency for adults and it is essential for a healthy immune system. Boston researchers found that high levels of homocysteine can potentially damage the brain by two paths. First, by increasing the risk for cardiovascular disease, which can impair blood function to the brain. Second, homocysteine is converted to an amino acid that stimulates brain cell receptors at normal levels, but can cause the cells to self-destruct at excess levels.  
 
AND:
About alcohol and paracetamol (acetaminophen/tylenol)
Quote:

RXLIST: ALCOHOL WARNING: If you generally consume 3 or more alcohol-containing drinks per day, you should consult your physician for advice on when and how you should take acetaminophen and other pain relievers.

Quote:

MED CHECKER: Major Drug-Drug Interaction: acetaminophen (acetaminophen) and ethanol (ethanol): GENERALLY AVOID: Chronic, excessive consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity, which has included rare cases of fatal hepatitis and frank hepatic failure requiring liver transplantation. The proposed mechanism is induction of hepatic microsomal enzymes during chronic alcohol use, which may result in accelerated metabolism of acetaminophen and increased production of potentially hepatotoxic metabolites. MANAGEMENT: In general, chronic alcoholics should avoid regular or excessive use of acetaminophen. Alternative analgesic/antipyretic therapy may be appropriate in patients who consume three or more alcoholic drinks per day.

ALSO:
About alcohol and cough syrups (which may contain alcohol or dextramethorphan or paracetamol/acetaminophen/tylenol):  The interaction between destramethorphan (DXM) and other substances (e.g., alcohol, acetaminophen,  and other OTC cough medicines) produces a synergistic effect that can be very dangerous. Ingredients of cough medicines like acetaminophen are extremely hazardous when consumed in high doses and can cause liver damage, heart attack, stroke, and death.
 
For pharmaceutical information and drug interactions:
(1)  http://www.crazymeds.org/ .  (main CrazyMeds site)
(2)  http://www.rxlist.com .  (patient information for all drugs; click on generic section, though)
(3)  https://www.aidsmeds.com/cmm/DrugsNewContent.asp .  (med-interaction-checker)
 
The SSRI may not be the big offender.  However, alcohol reduces the effectiveness of SSRIs, even if he were taking them properly.  Cipramil can cause fatigue.  That, the cough syrups, and moreso the drinking, would tend to explain his sleeping in.  More importantly, the sum total of what he’s taking adds up to risky business.  Oh, well.  You can print this out to show him, if you like.  Be prepared for disinterest, however.  Doesn’t sound as if he cares much about his health.
 
Adieu

StrungOutOnLife answered 3 years ago

Re: Cipramil interactions?
Hold the fuck on: he’s got manic-depression and he’s taking only Cipramil? Jesus H. Christ! Go read Dr. Phelps’ page on why that’s a bad idea in bipolar disorder as it’s now called–you see, “manic-depression” doesn’t include hypomania or mixed states and where are all the bipolar II people going to go?

contradiction answered 3 years ago

Re: Cipramil interactions?
Yeah, a doctor once prescribed me Celexa alone because he didn’t believe I was bipolar…in the process of proving him wrong, life was suckin’ ass.  
 
It sounds like he wants attention, and if the doc just prescribed Celexa he either thinks the guy isn’t bipolar (maybe unipolar), or the doc doesn’t know what he’s doing. Of course, I am just a lunatic, don’t listen to me.  
 
Did you actually notice any symptoms of bipolar disorder in your roommate? I mean, you think you would have thought something was wrong. It’s really hard to live with an unmedicated bipolar…or so I hear. Wink

KMMH asked 3 years ago

My flatmate and I are studying biology, and in a lecture he heard about manic depression, decided that was him and got perscribed Cipramil 20mg. Since he’s been taking it, he takes it erraticaly (often waiting for an audience to pull the pills out of his bag and show them off), and technically binge drinks on them (2-3 bottles of wine one day, a few hours in a pub another day). He’s complained that he’s got a constant cough and is now taking paracetamol and cough bottles and herbal tinctures etc etc often. He’ll also sleep in until around 12:00 when he wouldn’t normally before. I haven’t noticed any great change in his “mood”, neither has anyone else close to him.
 I was wondering several things.  I know mixing alcohol and medications is the wrong thing to do, but what can actually happen when you mix an SSRI and alcohol? What about mixing it with paracetamol and cough bottles on a regular basis? And are there any medical/pharmaceutical text books I could find information in?
 Of course it’s not my medication and therefore not my choice, but what my friend is doing can’t be good for him, not to mention that other friends with experience of anti-depressant medication find it demeaning that he takes these drugs aparantly so flippantly.

2 Answers
adieuolivaw answered 3 years ago

Re: Cipramil interactions?
Hi, KMMH!
 
About alcohol and SSRIs
Quote:

CRAZY MEDS: You know the drill, you shouldn’t drink when on meds, but come on. Just because I’ve given up booze doesn’t mean I’m going to get all preachy on you. Basically with the newer antidepressants, booze isn’t that big a deal.

HOWEVER…
About alcohol and folic acid:  Alcohol creates folic acid deficiency, which results in too-high levels of homocysteine, which weakens the immune system, which can cause infections and immune diseases. Lack of folate is the most common vitamin deficiency for adults and it is essential for a healthy immune system. Boston researchers found that high levels of homocysteine can potentially damage the brain by two paths. First, by increasing the risk for cardiovascular disease, which can impair blood function to the brain. Second, homocysteine is converted to an amino acid that stimulates brain cell receptors at normal levels, but can cause the cells to self-destruct at excess levels.  
 
AND:
About alcohol and paracetamol (acetaminophen/tylenol)
Quote:

RXLIST: ALCOHOL WARNING: If you generally consume 3 or more alcohol-containing drinks per day, you should consult your physician for advice on when and how you should take acetaminophen and other pain relievers.

Quote:

MED CHECKER: Major Drug-Drug Interaction: acetaminophen (acetaminophen) and ethanol (ethanol): GENERALLY AVOID: Chronic, excessive consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity, which has included rare cases of fatal hepatitis and frank hepatic failure requiring liver transplantation. The proposed mechanism is induction of hepatic microsomal enzymes during chronic alcohol use, which may result in accelerated metabolism of acetaminophen and increased production of potentially hepatotoxic metabolites. MANAGEMENT: In general, chronic alcoholics should avoid regular or excessive use of acetaminophen. Alternative analgesic/antipyretic therapy may be appropriate in patients who consume three or more alcoholic drinks per day.

ALSO:
About alcohol and cough syrups (which may contain alcohol or dextramethorphan or paracetamol/acetaminophen/tylenol):  The interaction between destramethorphan (DXM) and other substances (e.g., alcohol, acetaminophen,  and other OTC cough medicines) produces a synergistic effect that can be very dangerous. Ingredients of cough medicines like acetaminophen are extremely hazardous when consumed in high doses and can cause liver damage, heart attack, stroke, and death.
 
For pharmaceutical information and drug interactions:
(1)  http://www.crazymeds.org/ .  (main CrazyMeds site)
(2)  http://www.rxlist.com .  (patient information for all drugs; click on generic section, though)
(3)  https://www.aidsmeds.com/cmm/DrugsNewContent.asp .  (med-interaction-checker)
 
The SSRI may not be the big offender.  However, alcohol reduces the effectiveness of SSRIs, even if he were taking them properly.  Cipramil can cause fatigue.  That, the cough syrups, and moreso the drinking, would tend to explain his sleeping in.  More importantly, the sum total of what he’s taking adds up to risky business.  Oh, well.  You can print this out to show him, if you like.  Be prepared for disinterest, however.  Doesn’t sound as if he cares much about his health.
 
Adieu

StrungOutOnLife answered 3 years ago

Re: Cipramil interactions?
Hold the fuck on: he’s got manic-depression and he’s taking only Cipramil? Jesus H. Christ! Go read Dr. Phelps’ page on why that’s a bad idea in bipolar disorder as it’s now called–you see, “manic-depression” doesn’t include hypomania or mixed states and where are all the bipolar II people going to go?

contradiction answered 3 years ago

Re: Cipramil interactions?
Yeah, a doctor once prescribed me Celexa alone because he didn’t believe I was bipolar…in the process of proving him wrong, life was suckin’ ass.  
 
It sounds like he wants attention, and if the doc just prescribed Celexa he either thinks the guy isn’t bipolar (maybe unipolar), or the doc doesn’t know what he’s doing. Of course, I am just a lunatic, don’t listen to me.  
 
Did you actually notice any symptoms of bipolar disorder in your roommate? I mean, you think you would have thought something was wrong. It’s really hard to live with an unmedicated bipolar…or so I hear. Wink