Meds and Alcohol
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I am currently taking Depakote 750mg./day and am curious if drinking alcohol poses dangers. If so what exactly are they?

Dear Kris --
Good on ya' for asking.  This must apply to a lot of folks out there, since the national U.S. figures show about 50% of people with bipolar disorder are using alcohol or some street drug -- yet few people ask questions like yours.  So, that's great.

I'd love to tell you that "oh, when you're taking Depakote, you shouldn't drink any alcohol, that's really dangerous".  You know, the scare tactic route?  But there are no such clear dangers.  Depakote can bother your liver and you pancreas; so can alcohol.  So the two together may not be a great idea, but most people with normal blood tests for liver and pancreas are probably not taking a very big risk by combining the two (if you were to continue both, you should have your doc' do such a test).

The real risk with alcohol is what it does to bipolar disorder itself.  In my experience with patients, they seem to have concluded that about 1 drink per week is the maximum they can afford without destabilizing their illness.  More than one at a time, or more than one a week, seems to cause sleep problems and a return of symptoms.

I tell my patients to go 2 months with no alcohol at all.  Then, knowing what the medications are capable of producing in terms of mood stability, they can do what they choose.  Most of them then seem to be able to recognize that even moderate amounts of alcohol have quite an impact (basically making the medication ineffective).  There's not much point in taking the medication and then reversing it with another "medication", so most of them give up the alcohol except as a rare thing, in a social circumstance.  For some people, it isn't as easy as that: they may need some treatment focus directly on the alcohol.

Dr. Phelps

Published November, 2000

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