Alcohol and ADHD Medication

From the WebMD Archives

If you take medication for your ADHD, you may wonder whether or not you can drink alcohol. And if it's okay, how much can you safely have?

There's no official recommendation, because not enough research has been done. But some doctors think a drink or two is all right for some people under certain circumstances. It depends on the person, the type of medication they take, and when they took it last.

The two types of drugs that treat ADHD -- stimulants and nonstimulants -- mix differently with alcohol.

Stimulant Meds

Most people with ADHD take these. They help you stay alert and focus. They boost the release of chemicals in the brain that help your brain cells, called neurons, talk to each other.

Alcohol is a depressant. Stimulants can make its effects of alcohol stronger, but at the same time, you may be less likely to realize it. That's because the medication delays that sleepy, drugged-out feeling you get when you've had too much to drink.

If you're on a stimulant while having some cocktails, you may not notice your body's natural cues that it's time to stop. You could risk alcohol poisoning or a drinking-related accident. Having both booze and a stimulant in your system also raises the risk of heart-related issues.

The amount of alcohol that would give a person not on medication a minor "buzz" could make someone taking these meds drunk. The medicines affect how booze is broken down in the body and can lead to higher blood alcohol levels.

"I recommend drinking no more than one serving of alcohol," says Denise Leung, MD, an assistant professor of psychiatry at Columbia University Medical Center in New York.

You need to factor in when you last took your medication, and how long the stimulant works in your system. Short-acting (immediate release) medications, which are taken a few times a day, usually last about 4 hours. Long-acting (extended release) medications are meant to last the whole day, and are usually taken in the morning.

"If [a patient] takes a short-acting stimulant in the morning, I'd recommend they wait until the evening before they consider the one drink of alcohol. With a long-acting stimulant, I would recommend they wait at least 12 hours," Leung says.

Continued

"I advise my patients to wait until the stimulant has worn off before using alcohol, and to drink alcohol in moderation," says Edward (Ned) Hallowell, MD, a psychiatrist and ADHD expert.

David W. Goodman MD, an assistant psychiatry professor at Johns Hopkins School of Medicine, says he'd tell his patients to have no more than two drinks. But he warns, "Some patients tell me they feel more hung over in the morning than usual, even if they've separated their stimulant and alcohol use by several hours."

Nonstimulant Meds

Doctors recommend caution with these medications, too.

You may be more likely to feel the effects of alcohol while on nonstimulants. It can take a higher toll on your motor skills, and it may heighten symptoms of depression.

Alcohol is cleared from your body by your liver, as are many medications. Mixing the two can raise your risk of liver problems. It increases the risk of side effects such as nausea and headaches, and it can make you dehydrated.

ADHD and Addiction

There's a strong argument for avoiding alcohol altogether. When you have ADHD, you're already at higher risk of developing alcohol and substance abuse problems. It's estimated that 20% to 50% of adults diagnosed with the disorder also abuse alcohol or drugs.

Many people with ADHD have a hard time controlling their impulses. Do you have trouble setting limits? Do you know you'll be able to stop after a drink or two?

"I monitor substance use with my patients carefully. Learning moderation, if possible, is key. Otherwise abstinence becomes the rule," Hallowell says.

The bottom line? If you take any medication, you shouldn't drink alcohol without talking to your doctor about it first.

WebMD Feature Reviewed by Smitha Bhandari, MD on February 29, 2016

Sources

SOURCES:

Lakhan, S. Brain and Behavior, Sept. 2, 2012.

GoAskAlice.Columbia.edu: " Adderall: Health risks when combined with alcohol?"

CHADD: "The Science of ADHD"

ADDiTude: "Alcohol and ADD Medication: What Is Safe?

SteadyHealth.com: "Side Effects Of Mixing Adderall And Alcohol?"

AddictionBlog.org: "What Does Adderall Do In The Body? Adderall And The Brain"

Xiangyang, J. Journal of the American Board of Family Medicine, January/February 2009.

National Institute on Alcoholism and Alcohol Abuse. "What Is A Standard Drink?"

Bradley, S. Alcohol Research and Health, 2002.

MedicineNet: "Nonstimulant Therapy and Other ADHD Drugs."

Denise Leung, MD, assistant professor of psychiatry, Columbia University Medical Center.

David W. Goodman M.D., FAPA, assistant professor, department of psychiatry and behavioral sciences, Johns Hopkins School of Medicine.

Edward (Ned) Hallowell, MD, founder The Hallowell Center.

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