Saturday, March 24, 2007

Alcohol Cravings Induced via Increased Serotonin

Alcohol Cravings Induced via Increased Serotonin
by Ann Blake Tracy, Director, ICFDA

There is an alarming connection between alcoholism and the various prescription drugs that increase serotonin. The most popular of those drugs are: PROZAC, ZOLOFT, PAXIL, LUVOX, SERZONE, EFFEXOR, ANAFRANIL, and the new diet pills, FEN-PHEN and REDUX. For seven years numerous reports have been made by reformed alcoholics (some for 15 years and longer) who are being "driven" to alcohol again after being prescribed one of these drugs. And many other patients who had no previous history of alcoholism have continued to report an "overwhelming compulsion" to drink while using these drugs.
(A few personal accounts: #1 A young woman, a recovering alcoholic, reported that during the eight month period she had been using Prozac she found it necessary to attend AA meetings every day in order to fight off the strong compulsions to begin drinking again. #2 In the Southeastern United States a middle aged psychologist, also a recovering alcoholic, after being prescribed Prozac, found herself needing to attend AA meetings morning, noon, and night to keep from destroying the sobriety she had achieved. #3 A young father, who was Mormon and had never before in his life used alcohol, found himself drinking Ever Clear and exhibiting bizarre as well as violent behavior, after being prescribed Prozac and Ritalin. #4 A young mother who had never used alcohol before began drinking large amounts within weeks of being prescribed Prozac and quickly found herself committed to a mental institution due to the psychotic behavior that resulted. Added to her Prozac prescription were anti-psychotic meds and electric shock treatments. She then began to experience seizures and was started on anti-seizure meds. #5 A concerned neighbor reported her friend was drinking straight Vodka on a regular basis after being prescribed Zoloft. #6 A daughter reported her father, sober for 15 years, began drinking again on Prozac. The consistant report from these patients has been an "overwhelming craving or compulsion" for alcohol.)
For some time we did not have specific medical documentation to help us understand why this was happening. Could it be that Prozac, Zoloft, Paxil, etc., being mood altering substances, were removing the inhibitions that individuals had placed upon themselves to stop their additions? But beyond this mood altering effect of Prozac, etc., there seemed to be a physiological cause for this alcoholic obsession as well. There were reports of people who rarely drank before Prozac, etc., consuming excessive amounts of alcohol after starting usage of these various drugs. For example we have the case of a young newly wed in Southern Utah who was given Prozac for a hormonal imbalance. Before that time she would have two or three social drinks a year, yet soon after being prescribed Prozac she began bringing alcohol home by the case. Many similar reports followed.
Could it be that because these drugs have such a strong adverse effect upon the pancreas [Manufacturer's warnings include such side effects as hypoglycemia, diabetes and pancreatitis.] they are producing a potent disruption in the body's blood sugar balance? This would in turn cause a "craving" for alcohol as the body reaches out for a "quick fix" to raise the blood sugar level thus triggering a vicious self-perpetuating cycle as the alcohol pushes the blood sugar level even lower after the brief high it produces. This means that those suffering a tendency toward alcoholism or any other blood sugar disorder would suffer the most disastrous repercussions of Prozac, etc., (including psychosis, suicidal ideation and violence) much faster than most. Patient reports support this conclusion.
In November of 1994 Yale published a study that gave us one answer to the alcohol cravings associated with these drugs. The study demonstrated that an increase in brain levels of either of two neurotransmitters (brain hormones), serotonin or noradrenalin, produces: #1 a craving for alcohol, #2 anger, #3 anxiety. They found this to be especially true for those who have a history of alcoholism. All of the drugs listed above are designed in one way or another to increase serotonin which in turn also increases noradrenalin. Anyone who has a history of alcoholism should heed the warning contained in these reports. And anyone who has developed a problem with alcoholism while using these drugs deserves answers as to why they have experienced such an overwhelming compulsion to drink.
America already has an estimated 10 -15 million alcoholics. To increase that number with a reaction from prescription drugs which causes a compulsion to drink is a tragedy! What a sad state of affairs that drugs which are actually being promoted as a treatment for alcoholism have the potential to create alcohol craving behavior. This is not only frightening, but absurd. It is heart-rending to listen to those who have had years of sobriety destroyed almost overnight or those who have never touched alcohol before Prozac, yet began drinking compulsively due to a medication prescribed by doctors unfamiliar with this connection. By chemically inducing an overwhelming urge to drink this effect also causes patients to mix alcohol with these powerful drugs. When alcohol and drugs are combined, one can compound the effects of the other so the resulting impairment is far worse than if the two were taken separately...even small amounts, mixed with some medicines, will deaden your senses or change your perceptions which can lead to psychotic behavior, seizures, etc. Those in this situation need to be made aware that they are not alone, and that this is a common report which is now substantiated by medical documentation. They also need to understand that it is possible to very gradually withdraw from these drugs and overcome these adverse drug reactions.
For an in depth exploration of this subject see the book PROZAC: PANACEA OR PANDORA? by Ann Blake Tracy. For order information call 1-800-280-0730 or visit the website.
Other references for this material: Krystal JH, Webb; E, Cooney N.; et al., "Specificity of Ethanol-like Effects Elicited in Serotonergic and Noradrenergic Mechanisms," ARCHIVES OF GENERAL PSYCHIATRY, Vol. 51, Issue 11, pgs 898-911. (This is the Yale study mentioned above.); In a study conducted by Liisa Ahtee and Kalervo Eriksson (Physiology and Behavior, Vol. 8, pp. 123-126, 1972) rats which preferred alcohol had 15-20% higher concentrations of serotonin in the brain.


Diabetics commonly experience hypoglycemia (low blood sugar levels). And what are the symptoms? Slow and slurred speech, poor balance, impaired motor control, staggering, drowsiness, flushed face, disorientation -- in other words, the classic symptoms of alcohol intoxication. This individual will look and act like a drunk driver to the officer, and will certainly fail any DUI "field sobriety tests". As one expert has observed, "Hypoglycemia (abnormally low levels of blood glucose) is frequently seen in connection with driving error on this nation’s roads and highways...Even more frequent are unjustified DUIs or DWIs, stemming from hypoglycemic symptoms that can closely mimic those of a drunk driver." From "Hypoglycemia: Driving Under the Influence" in 8(1) Medical and Toxicological Information Review Sept. 2003.
Canadian scientists have reported that "approximately 200 compounds have been detected in the human breath." Manolis, The Diagnostic Potential of Breath Analysis, 29(1) Clinical Chemistry 5 (1983).
This study confirmed the presence of acetone on the breath in diabetics and in persons on a diet " associated with a weight reduction of about one-half pound per week." Id. at 9. Another study has confirmed that diabetics may give false indications of intoxication. In Brick, Diabetes, Breath Acetone and Breathalyzer Accuracy: A Case Study, 9(1) Alcohol, Drugs and Driving (1993), a researcher found that expired ketones in the breath of an untreated diabetic can contribute to erroneously high breath-alcohol readings. Further, the acetone on the breath from ketoacidosis will result in an odor of alcohol. Finally, behavioral patterns of a diabetic whose blood-sugar level has dropped will include slurred speech, slow gait, impaired motor control, fumbling hand movements, and mental confusion--all symptomatic of intoxication.
Acetone may also be found on the breath of perfectly normal, healthy individuals. Yet, acetone is one of the compounds that will be detected on many breath analyzing instruments as ethanol. In the Intoxilyzer, for example, it is detected because acetone absorbs infrared energy in the 3.38 to 3.40 micron range--the same range where ethanol is found. Therefore, if acetone were introduced into the Intoxilyzer, the machine would simply register the presence of alcohol despite its absence. If an individual had 525 micrograms per liter of acetone in the breath, he would register a blood-alcohol level of .02 to .03 percent. Thus, if an individual with a true blood-alcohol level of .08 percent had that amount of acetone, the Intoxilyzer would register in the area of .l0 to .11 percent.
The National Highway Traffic Safety Administration has published a report entitled The Likelihood of Acetone Interference in Breath Alcohol Measurement (DOT HS--806-922). The report basically summarizes scientific literature on the subject, concluding that normal individuals have insignificant levels of acetone on their breath. The data indicated, however, that dieters can have higher levels and that diabetics not in control of their blood-sugar had levels hundreds or even thousands of times higher than normal
a study confirming the effects of acetone in diabetics can be found in Mormann, Olsen, Sakshaug, and Morland, Measurement of Ethanol by Alkomat Breath Analyzer; Chemical Specificity and the Influence of Lung Function, Breath Technique and Environmental Temperature, 25 Blutalkohol 153 (1988). Diabetic subjects in that study also were found to have acetone levels sufficient to produce breath-alcohol readings of .06 percent.

Breath testing machines, such as the Intoxilyzer 5000, suffer from a little-known design defect: they do not actually measure alcohol! Rather, they use infrared beams of light which are absorbed by any chemical compound (including ethyl alcohol) in the breath which contains the "methyl group" in its molecular structure; the more absorption, the higher the blood-alcohol reading. The machine is programmed to assume that the compound is "probably" alcohol. Unfortunately, thousands of compounds containing the methyl group can register as alcohol. One of these is "acetone". And a well-documented by-product of hypoglycemia is a state called "ketoacidosis", which causes the production of acetones in the breath. In other words, the Breathalyzer will read significant levels of alcohol on a diabetic’s breath where there may be little or none. See, for example, Brick, "Diabetes, Breath Acetone and Breathalyzer Accuracy: A Case Study", 9(1) Alcohol, Drugs and Driving (1993).
Fact: roughly one in seven sober drivers on the road suffers from diabetes.