Dear Alice,

I am currently on Prozac and at college. I'm just wondering, what would happen if I stopped taking Prozac for one or two days before the weekend so that I could drink alcohol without feeling extremely sleepy? When I start taking the Prozac the next morning after drinking, will it be like starting the Prozac from square one? How long does Prozac stay in the body for?

perplexed about prozac

Dear perplexed about prozac,

Prozac, generically known as fluoxetine, is a drug prescribed for depression and obsessive compulsive and panic disorders. Fluoxetine takes a few days to leave your system after you stop taking it. Even if you lay off before the weekend, you probably won't escape whatever side effects or interactions the drug causes in you, with or without alcohol. Similarly, if you start taking fluoxetine again after a few days off, you won't be starting again from square one. While skipping a day or two of fluoxetine may not be particularly harmful, it's a bad idea to stop taking the medication cold-turkey — fluoxetine and other anti-depressants, such as venlafaxine HCl, need to tapered off gradually in order to give the body time to adjust to the change.

Fluoxetine is part of a family of drugs called selective serotonin reuptake inhibitors (SSRIs). SSRIs are used to treat depression because they affect how the brain absorbs serotonin, a chemical that transmits impulses between nerves and affects mood. Information conflicts on the effects of drinking alcohol while taking fluoxetine. Some studies suggest that SSRIs don't make the effects of alcohol stronger; nonetheless, SSRI manufacturers advise against drinking while taking an SSRI. They say that the combination can make a person drowsy (similar to what you describe), decreasing coordination and impairing judgment — more so than would be caused by drinking alcohol alone. Many health care providers also recommend against drinking alcohol while taking SSRIs because alcohol, a depressant, may interfere with the medicine's therapeutic benefits. Again, anti-depressant drugs other than fluoxetine may interact differently with booze. A family of anti-depressants drugs called tricyclics (drugs such as amitriptyline and nortriptyline), for example, can cause serious problems if taken with alcohol.

You might consider your drinking patterns. For example, if your medication works for you, then why mess with it or change your medication routine to drink? What does drinking alcohol offer you? How would you feel about not drinking? How much do you usually drink at a time, over what period on a weekend? How much alcohol do you drink when you get so sleepy?

Rather than altering your medication, a different plan could help you be a more-awake weekend partier. You could cut back on the amount of alcohol you drink, imbibe more slowly, sip rather than gulp, drink water between sips, and be sure to eat, to help absorb the alcohol. If the idea of going out and enjoying the bar and party scene appeals to you, is it possible to still have fun at these social venues sans alcoholic beverages?

Finally, since drugs affect people differently, it's smart to pay attention to how you react to any drug. Since you're concerned about your drowsiness or any other ways alcohol affects you while you're taking this anti-depressant, a conversation with your health care provider is a good idea. It can give the provider information s/he may need to make necessary changes in your medication, dosage, or treatment plan.


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