Brief Answer:
The safe amount of alcohol that can be consumed depends on the gender, the presence of chronic conditions, and regular use of medications- details below

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,

I carefully read your query and understand your concern.

The amount of alcohol that the body can metabolize without exhausting the capacity of the liver varies from patient to patient and if there is any chronic condition present, especially if there are present diseases that affect the liver (hepatitis, or other chronic liver diseases).

As a general rule, a healthy male should not consume more than 21 units of drinks in a week and a healthy female should not consume more than 14 units of drinks in a week.

A unit of alcoholic drink is 2/3 of a standard glass of wine (125 ml), one small glass of beer (330 ml) and as for the colored alcoholic drinks this varies, a lot among them and more specific information is needed to calculate the amount of alcohol in them.
To assist you to calculate this, one unit of alcohol equals 10 ml of pure alcohol or 8 g. So, if you consume a certain drink, you may need to calculate the amount of pure alcohol used and convert it into units.

The total weekly amount is what is generally used as a way to calculate. So, there are no specific rules if you use certain amounts in a day or you take a break another day. It is important that in a week the total amount is not exceeded.

If a patient has chronic conditions such as hepatitis, cirrhosis, bile problems, fatty liver, diabetes or other conditions that may affect the liver, or the patient uses paracetamol or other medications that are metabolized in the liver, then the safe amount of alcohol that can be consumed is much less (there is no specific rule in this case to calculate the units) and it is safer to not consume alcohol at all in this cases.

To conclude:

- In healthy individuals, less than 21 units of alcohol should be consumed in a week from men and less than 14 units a week for women.
- It is best to calculate the units of alcohol by considering that one unit of alcohol equals 10 ml of pure alcohol (which equals 8 g of pure alcohol).
- The total amount in a week is what is generally considered and not certain days
- If there are chronic conditions or patient uses paracetamol or other drugs that affect the liver regularly, the risk of liver damage is present even with much smaller doses so it is safer to just abstain from using alcohol.

I hope this answers your query. I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
Due to fatty liver and the use of antipsychotics, it is best to avoid alcohol

Detailed Answer:
Hello and welcome back,

Most antipsychotics are metabolized in the liver and may cause liver injury. Fatty liver disease can be the first step of liver damage by these drugs or due to metabolic syndrome (being overweight, having high lipids in the blood, etc).
So, it is clear in your case that the liver is already being affected and is under stress. Antipsychotics are drugs that need to be used daily, and meanwhile, liver tests should be conducted regularly to monitor their effect on the liver and make sure to identify damages early, if any happens.

Consuming alcohol may speed the liver damage and cause your liver to fail. So, there is no safe amount of alcohol that you can use. Also, alcohol may cause the liver enzymes to rise and the doctor will not be able to determine if this raise is due to the medications or alcohol and this may affect your further treatment with the antipsychotic.

To conclude:
- antipsychotics may affect the liver and cause injuries to it
- fatty liver disease is an indication that your liver is already under stress (due to the medications or due to being overweight or having high lipids)
- alcohol may further worsen this and speed the liver damage so there is no way to calculate a safe amount of alcohol that you can use.
- fatty liver is a reversible liver disease, so if you are cautious and take care to not add unnecessary stress to it, you may prevent further progress to irreversible stages.
- please be reminded that alcohol use may affect the treatment with antipsychotics as well as these two interact with one another and also due to liver damage by the alcohol the doctor may decide to stop your antipsychotic (antipsychotics should be stopped if transaminases raise more than 3x the normal range).
- finally, if you are using alcohol for a while and you are dependent to it, it is not advised to stop abruptly. You may need to have a visit with your doctor and decide on a plan for a safer, easier and more successful way of withdrawing from alcohol.

I hope this answers your query. I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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