QUESTION:
Dear Dr. Heller,
Hello, I am 28, male, and have been taking Paxil for social anxiety disorder for about 3 months and am now up to 40mg a day. My doctor has repeatedly warned me that drinking alcohol will cancel the effects of Paxil. I am realizing that the amount of alcohol I have been drinking in the past and now (about 1 - 2 drinks everyday - average) is due in large part because of my anxiety. I am hoping that the Paxil will make me want to drink less alcohol as it alleviates certain fears, but I am worried that I won't reach this level because the drug isn't working as it should - a kind of catch 22. My fears arise in any closed environment with more than a few people (i.e. classrooms, work meetings, social situations). I feel a "little" better with the Paxil so far - but am still having a hard time cutting back the amount of alcohol (and I really do want to cut back!). Please tell me if the alcohol is undercutting the effects of the drug. Also, what's the average and maximum number of milligrams for this drug?
Thanks so much.
ANSWER:
Your physician is correct. When you consume alcohol it temporarily renders SSRI
medications like Paxil useless. This means your underlying symptoms will get worse.
I'd be highly suspicious that you're treating other diagnoses with alcohol. The
most likely would be the generalized anxiety disorder, especially the cognitive component
(persistent worry, mind always going). I'd highly recommend doing the
screening test
to see if there are other diagnoses that also need
to be treated medically.
