Evaluation of Possible Interactions between Ethanol and Trazodone or Amitriptyline

Abstract

The pharmacodynamic effects of single doses of trazodone (100 mg), amitriptyline (50 mg) or placebo either alone or with ethanol (0.5 ml/kg) were investigated in 6 healthy volunteers in a double-blind crossover study. Plasma concentrations of the drugs and ethanol were also measured. Pharmacodynamic tests were critical flicker fusion frequency threshold (CFF), choice reaction time (CRT), manual dexterity, a digit span test and visual analogue scales. Blood ethanol concentrations were not influenced by the co-administration of either antidepressant. t_max for trazodone was prolonged by ethanol but the other pharmacokinetic parameters for trazodone and amitriptyline were not influenced by ethanol. Trazodone and amitriptyline caused the expected profound depressant effects on CFF, CRT, manual dexterity and on the rating scales for drowsiness, ‘clearheadedness’, aggression and disinhibition. Ethanol alone impaired manual dexterity, increased drowsiness, reduced ‘clearheadedness’ and also tended to reduce feelings of aggression. In combination with either trazodone or amitriptyline, ethanol caused little additional effect except in the case of manual dexterity, which was further impaired. This result may reflect the profound effects of the antidepressants alone and does not suggest that it is safe for patients receiving antidepressant medication to take ethanolic drinks.

Antidepressants and memory: A review

“…One involved no memory tests, although deficits were noted on other measures (Burns et al, 1986). Warrington et al (1984) reported no effect on shortterm memory; however, detrimental effects of the drug were noted on other measures including tests of manual dexterity and reaction time. In combination with trazadone, ethanol caused little additional effect.…”

“…Seven reported some detrimental effects (Liljequist et al, 1978;Peck el al., 1979;Branconnier et al, 1982;Linnoila et al, 1983;Warrington et al, 1984;Curran et al, 1988;Moskowitz and Burns, 1988). The other two found no influence on test scores, although in both assessment was confined to a single measure of short-term memory (Bye et al, 1978;Patat et al, 1988).…”

Treatment of Sleep Disturbance in Alcohol Recovery

“…It is also one of the most commonly prescribed medications for sleep disturbance nationwide, 17 though hypnotic efficacy data in the general population remains inadequate. Trazodone is well tolerated, 18,19 is safe in combination with alcohol (except, perhaps, in massive overdose), [20][21][22][23][24][25][26] has low abuse potential, 27,28 is effective at bedtime dosing, [29][30][31] and has analgesic effects similar to amitriptyline. [32][33][34] Trazodone's analgesic effect may be important because of a recently observed association between alcohol dependence, disturbed sleep and pain.…”

A psychopharmacological study to assess anti‐muscarinic and central nervous effects of medifoxamine in normal volunteers

“…There were 23 stimulus presentations, and total reaction time and response reaction time were taken as the mean of the last 20 presentations. Manual dexterity was assessed by recording the time taken for the subject to pick up from a tin lid (diameter 76mm) 50 air-gun pellets (diameter 56 mm) one at a time, and drop them down a glass tube of 6 mm bore into a container (Warrington et al, 1984). Visual analogue self-rating scales were used to assess subjective symptoms of sedation (0 mm I feel very alert, 100 mm I can hardly keep awake), dryness of the mouth (Omm My mouth is not dry at all, 100mm My mouth is absolutely dry), nausea (0 mm I do not feel nauseous at all, IOOm I feel very nauseous), and appetite (Omm I am not…”