Best Evidence Webinar: Antidepressants and substance misuse; what’s going on?

19 Jul 2023 Best Evidence Webinar: Antidepressants and substance misuse; what’s going on?

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Posted at 12:00h in Education, Podcasts & Videos by

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In this webinar, Dr. David Menkes explored the interaction between SSRI antidepressants and substance misuse. Using a series of 100 cases, Dr. Menkes had already documented an interaction between alcohol and SSRI antidepressants, including pathological intoxication and a variety of severe outcomes (including homicide).

Dr. David Menkes is an academic psychiatrist with a background in psychology and pharmacology (MD 1982; PhD 1983, Yale).  Since completing specialist training in Dunedin (FRANZCP 1989) he has worked as a liaison psychiatrist in NZ and the UK.  He has research and clinical expertise in the pharmacology of drug treatments in psychiatry, with a particular focus on the adverse effects of psychotropic medications, their interaction with other prescribed drugs and with alcohol. In July 2023 he spent a month at the Therapeutics Initiative in Vancouver, BC, Canada as part of a short study leave.

WHEN: July 19, 2023 at 12:00 – 13:00 Pacific Time [convert to your local time]

WHERE: This is a free virtual event.

CME CREDITS: MainPro+/MOC Section 1 credits: 1.0. Those who attended the webinar and completed the evaluation will receive their certificate.

LEARNING OBJECTIVES

By the end of the presentation, attendees will be able to:

  1. Appreciate the common, generally unhelpful and sometimes harmful prescription of antidepressants to people with liabilities to substance misuse
  2. Consider possible mechanisms underlying aggravation of substance misuse by antidepressants
  3. Consider the obstacles in examining this problem and bringing it to the attention of prescribers and regulators

3 Comments
  • Paul Beckett
    Posted at 18:18h, 16 July Reply

    Wondering if since the misuse of substances is aggravated by antidepressants, there is also any evidence that the prescription of antidepressants actually leads to misuse of substances in the first place – Is Antidepressant prescribing an antecedent “trigger”?

    Paul Beckett, MD
    Vancouver, BC, Canada

  • emmanuelle laflamme
    Posted at 05:54h, 24 July Reply

    Similar question as above : can SSRI use lead to alcohol use in otherwise abstinent patients?

    Emmanuelle Laflamme, PharmD
    Montreal, QC, Canada

  • david menkes
    Posted at 19:40h, 27 July Reply

    Hello Paul and Emmanuelle,

    Thanks for your questions. To my knowledge, the best evidence is for
    1) people whose “normal” (non-problematic) drinking becomes an issue, and
    2) people with a history of drinking problems who get worse with SSRIs

    I think #2 would include those who are abstinent and relapse during SSRI treatment.

    As to those who don’t drink at all, what happens to them? I don’t know but would be interested in any observations you might make.

    Meanwhile, this is worth a read, relevant to group #1: https://slate.com/human-interest/2018/01/how-a-month-and-a-half-on-paxil-taught-me-to-love-being-shy.html

    Regards
    David B Menkes, MD PhD FRANZCP
    Year 5 psychiatry coordinator
    Associate Professor of Psychiatry
    Peter Rothwell Academic Centre
    Waikato Clinical Campus, University of Auckland
    Hamilton, New Zealand

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