Antipsychotics and Alcohol: Understanding the Risks and Interactions

Antipsychotics are medications developed to treat certain severe mental health disorders, like bipolar disorder and schizophrenia. They are only prescribed by licensed staff and should be used with caution because they can have serious side effects. Interaction with other substances (antipsychotics and alcohol, especially) can heighten those side effects or annul the effect of antipsychotics, […]

Antipsychotics are medications developed to treat certain severe mental health disorders, like bipolar disorder and schizophrenia. They are only prescribed by licensed staff and should be used with caution because they can have serious side effects. Interaction with other substances (antipsychotics and alcohol, especially) can heighten those side effects or annul the effect of antipsychotics, resulting in hallucinations and mania in some people. 

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Specialized organizations provide information on antipsychotic drugs and alcohol abuse problems, and they address both mental health and substance abuse problems. If you are experiencing any of these, a well-crafted mental health treatment can help you regain control over your life. We Level Up Treatment Centers can do exactly that.

Understanding Antipsychotics

Antipsychotics are a type of medication most frequently used to treat psychosis-related symptoms and conditions. They are usually prescribed to people who suffer from severe depression, certain forms of bipolar disorder, schizophrenia, schizoaffective disorder, and personality disorder. 

Receiving antipsychotics, however, does not necessarily mean you are being treated for psychosis. These medicines can also be used to treat certain health problems, such as physical problems (persistent hiccups, problems with balance, and nausea) and agitation and psychotic experiences in dementia. 

There are two main types of antipsychotics:

  • First-generation antipsychotics: They are known as typical antipsychotics. They were developed first, but now they aren´t commonly used.  
  • Second-generation antipsychotics: They are known as atypical antipsychotics, and they are now the main way to treat psychosis-related conditions. It´s mostly because they have fewer side effects. 

These medications can be taken in various ways, but typically, they are swallowed (in tablet or liquid form). Occasionally, they can be prescribed as a depot injection, and when administered in hospitals, they can even be inhaled. 

Antipsychotics act by impacting brain chemistry, more precisely dopamine. Neurological research explains that they block dopamine receptors (D2/3, not D1 or D4), and though several brain regions might be involved, ventral striatal regions may play a crucial role. The effect this has on patients is detachment from symptoms, relegation of the delusions and hallucinations to the back of their minds, rather than a complete erase of the symptoms.

Knowing how antipsychotics impact the brain and what effects they have is important to understand how antipsychotics and alcohol act together. Alcohol and antipsychotic medication are a combination professionals are warning about. 

Medicines of different shapes and sizes.
The alcohol and antipsychotic medication mixture is very dangerous.

Risks of Mixing Antipsychotics and Alcohol

To understand the interaction between alcohol and antipsychotics, you need to know what the potential side effects of taking antipsychotics are. There are quite a few side effects and potential health complications to taking antipsychotic medications, and here are a few:

  • Drug-induced muscle disorder: Both types of antipsychotics can cause the inability to hold still and Parkinsonism (tremors typical for Parkinson´s disease). 
  • Heart and circulatory problems: Antipsychotics may alter heart rhythm and cause blood pressure to drop when standing up too quickly, leading to fainting. 
  • Metabolism effects: Antipsychotic medications can cause high blood sugar and cholesterol. They also increase the risk of type 2 diabetes. 
  • High prolactin levels: Antipsychotics can affect a hormone called prolactin, affecting fertility and causing sexual dysfunction in men. 
  • Immune disruption: Some antipsychotics can weaken the immune system. 
  • Dizziness and sedation: All antipsychotics can have a sedative effect and make you tired. They can also cause dizziness, increasing the risk of falls and injuries. 
  • Interactions: It´s important to inform the healthcare provider if you´re taking any other medications or supplements, as there is a risk of interaction.

Mixing Antipsychotics and Alcohol: Physical Health Risks 

Keeping in mind that alcohol is a depressant, affecting heart rhythm, liver functioning, and the immune system and causing drowsiness, antipsychotics and alcohol combinations are likely to worsen side effects. Slowed breathing, slowed heart rate, low blood pressure, a drop in body temperature, fainting, seizures, and a higher risk of falls and injuries are the most common risks associated with alcohol and antipsychotic medication mixture. Professionals also warn about this combination causing liver damage. 

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Mixing Alcohol and Antipsychotics: Mental Health Risks

It is known that under the influence of alcohol, people engage in risky behaviors. Alcohol use disorder is also linked to mood disorder, and chronic alcohol use can cause hallucinations. All these symptoms of alcohol abuse can be found in certain mental conditions that require antipsychotics. Knowing this, we can expect antipsychotic drugs and alcohol combinations to lead to worsening of mental health symptoms as well. 

Alcohol can make it difficult for the body to absorb the medications, resulting in psychotic symptoms re-appearing. Hallucinations or delusions can return, as can states of mania. For some people, usually those who combine alcohol and antipsychotics by accident, this can be highly distressing. However, some intentionally mix alcohol and antipsychotic medication and find these symptoms exciting rather than alarming. 

Whether accidental or intentional, a mixture of antipsychotic drugs and alcohol can be very dangerous if the problem the antipsychotic was prescribed for is severe. For instance, if one drinks while on Abilify for severe bipolar disorder or schizophrenia, one might become a danger to oneself or others and act in a way that can cause death. 

Woman holding a glass of alcohol beverage, illustrating dangers of mixing alcohol and antipsychotics.
There are many negative side effects of combining antipsychotic drugs and alcohol.

Guidance for Patients Using Antipsychotics

Antipsychotics are prescription-only medicines, meaning the only way to acquire them legally is by having them prescribed, typically by a psychiatrist. Your general physician may sometimes prescribe them as well, especially if they are meant to treat some physical symptoms. In any case, you will get instructions on how to use them and a warning about their side effects.

It´s your responsibility to disclose if you are currently using any medications or supplements, as there can be interactions. More importantly, if you are struggling with alcohol use, you should share this information. It potentially makes you a candidate for a dual diagnosis, a condition where two mental issues co-occur, impacting the overall treatment you would be receiving. 

If you do not struggle with substance abuse, but it happens that you mix alcohol and antipsychotics occasionally due to environmental factors, be sure to know what side effects to expect and prepare those around you for it. Even better, try avoiding those environmental factors and ensuring you engage in alcohol-free socializing. Having support from your friends and family for this can significantly ease things.

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Support Services Offered by the Clinic Network

Whether you are struggling with a state that requires antipsychotics or with substance abuse, there is always a way to regain control over your life and achieve life satisfaction. It is, of course, easier to do so with support on your side. Friends and family are the support everybody needs, but sometimes it is not enough, and seeking professional aid can make all the difference. We Level Up Treatment Centers are here to aid your recovery and mental health care, no matter where in the US you find yourself. 

Some of our treatment centers specialize in mental health disorders, and their mental health hospitals offer a range of programs specifically tailored to your condition and circumstances. Others specialize in substance abuse and can offer both drug and alcohol addiction treatment consisting of medical detox, behavioral evidence-based therapy, group and individual support, as well as many additional programs aiming to support both you and your family long-term. To accommodate the different situations of our clients, we provide both inpatient and outpatient services, aiming to minimize disruption to your life while ensuring maximum efficiency of the treatment you are receiving. 

Finally, we are proud that our dual diagnosis treatment centers are able to address co-occurring problems and mental states. We understand not only the acute problem of mixing alcohol and antipsychotic medication but also the long-term consequences of repeated alcohol use leading to substance abuse problems and how it affects already existing mental health diagnoses. We Level Up Treatment Centers are able to assist you in this struggle by implementing a holistic approach that takes equal care of your body, mind, and spirit. 

A professional advising against mixing  antipsychotics and alcohol.
Professionals are strongly advising against mixing antipsychotics and alcohol.

Caution and Care: Navigating Antipsychotic Treatment and Alcohol Use

The development of antipsychotics was very welcomed by those struggling with psychosis-related conditions. Despite their negative side effects, antipsychotic medicines are changing many lives for the better and giving people with severe mental disorders a chance to live normal lives. Still, as with any other medicine, side effects can be very impactful, especially if one is not ready for them. Interactions with other substances, like alcohol, can worsen psychosis symptoms rather than alleviate them.  

Mixing antipsychotics and alcohol can be detrimental and dangerous for both the person consuming them together and people in their environment. Caution is more than advised, as is consultation with professionals, especially if you are sensing alcohol abuse disorder creeping in. 

We Level Up Treatment Centers are here if you need information, advice, or immediate help. Our professional and licensed staff can guide you and help you find your inner strength to reclaim your life.

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Kapur, S., Agid, O., Mizrahi, R. and Li, M. (2006). How antipsychotics work—From receptors to reality. NeuroRX, [online] 3(1), pp.10–21. Available at: