Antidepressants are a common treatment for individuals experiencing depression, anxiety, and other mental health conditions.
How alcohol interacts with these medications varies and depends on many factors.
Alcohol and antidepressants
Marc Tran/Stocksy United
Many people enjoy alcohol, often as part of social gatherings. However, for individuals with depression, anxiety, and certain other mental health conditions, alcohol use can affect and even worsen symptoms.
According to 2022 research, alcohol use may even cause depression and anxiety in some people.
In addition, many mental health conditions, including depression, may increase the risk of developing alcohol use disorder (AUD).
Lastly, there is a link between certain antidepressants and potentially serious side effects. If you take antidepressants, it’s important to consider your relationship with alcohol.
Sedation
Some antidepressants, such as citalopram and escitalopram, can increase the sedative effects of alcohol, leading to dizziness, confusion, and difficulty concentrating.
Trazodone, another antidepressant, can cause extreme drowsiness, especially when taken with alcohol. The combination can increase the risk of accidents or falls.
Further, you should avoid alcohol when taking brexanolone (Zulresso), an antidepressant used for post-partum depression, because both substances individually have sedative effects that may worsen when mixed. However, the sedative effects of Zelrosso alone should resolve quickly when treatment ends.
Liver damage
Alcohol use alone can increase the risk of developing liver problems.
This is especially important to consider if you take antidepressants, as some of these medications may also affect your liver health.
For example, case reports from 2021 describe how the antidepressants venlafaxine and duloxetine can lead to liver injury, though these were isolated events.
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Worsened mental health symptoms
Even though alcohol may make you feel happy or energetic in the short term, it is a depressant.
On its own, consuming alcohol can worsen the symptoms of depression or anxiety.
When combined with antidepressants, it can limit their effectiveness and make it more difficult to manage your symptoms.
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Antidepressants called monoamine oxidase inhibitors (MAOIs) limit how your body breaks down an amino acid called tyramine. Tyramine helps regulate your blood pressure.
Certain alcoholic beverages are high in this amino acid, including beer, red wine, sherry, and some liqueurs, so it’s best to avoid these specific drinks if you take MAOIs.
Seizures
Bupropion is another common antidepressant. Older types of this medication may be associated with an increased risk of seizures, although newer types may not carry the same risk.
Typically, healthcare professionals recommend that those taking bupropion avoid drinking alcohol.
General alcohol effects
Alcohol is a toxin, and drinking it is linked with many side effects — even without factoring in antidepressants.
In the short term, these include:
decreased coordination
longer reaction time
impaired judgment
nausea and vomiting
headaches
poor sleep
altered mood
slurred speech
inhibited memory
Long-term use can cause further adverse effects, including:
certain types of cancer
liver disorders
elevated blood pressure
dementia
addiction
osteoporosis
nutrient deficiencies
weight gain
Combining alcohol and antidepressants can cause other side effects that vary depending on your medication.
Are some better than others?
Certain antidepressants may be safer to take alongside alcohol consumption.
For example, a 2018 review showed how some medications, including sertraline and fluoxetine, might benefit the treatment of alcohol dependence. However, it is still important to use caution and limit alcohol consumption when taking these medications.
Your doctor can provide guidance on the safest and most effective treatment options for your condition.
If you choose to drink alcohol while taking antidepressants, it is important to do so in moderation and to avoid excessive drinking.
It is also important to monitor your symptoms closely and report any adverse side effects to your doctor, whether associated with alcohol use or not.
Summary
Combining alcohol and antidepressants can have negative effects, including increased sedation, impaired coordination, and worsening symptoms of depression or anxiety.
While some antidepressants may have a lower risk of side effects when taken with alcohol, it is important to use caution and limit alcohol consumption when taking any medication.
Always follow your doctor’s instructions and report any negative side effects to ensure you get the safest and most effective treatment for your specific condition.
Le Daré B, et al. (2019). Ethanol and its metabolites: Update on toxicity, benefits, and focus on immunomodulatory effects. https://pubmed.ncbi.nlm.nih.gov/31646907/