Question. I suffer from depression and have been on Prozac for a number of years now. It seems that after I have a few drinks, I notice a marked increase in my depression and irritability the next day. Could alcohol ingested in small amounts as this be causing a real chemical change in my brain, or am I just imagining this?
Answer. I know of at least one study showing no significant interaction between Prozac and alcohol, but everyone is different, and alcohol plus medication can interact in unpredictable ways. That’s why it is usually the doctor’s advice to avoid alcohol, or drink very sparingly, when taking psychotropic medication. It is possible that what you are experiencing are mild withdrawal symptoms as the alcohol is eliminated from your body, but this seems like a stretch to me.
For some people, even small amounts of alcohol can induce either depression or marked anger/aggression – perhaps you are experiencing a muted form of this reaction. (It would have been useful for me to know how you reacted to alcohol before you went on Prozac). Or, could it be that your feelings about drinking are affecting the way you feel the next day? There is some evidence that guilt feelings can worsen hangover from alcohol. I suppose that if you really want to investigate this phenomenon, you could try drinking a non-alcoholic beer (without knowing that it is) and compare it with your reaction to a similarly blinded trial with a regular beer, but beer contains many substances besides alcohol, and you could react even to a non-alcoholic beer. Bottom line: is it really worth pursuing this issue? Maybe the most sensible thing to do is avoid alcohol while you are taking Prozac.