Can You Drink Alcohol on Antidepressants?

Learn how alcohol can reduce the effectiveness of antidepressants, the potential side effects, and how to manage safely consuming alcohol while taking these medications.

Alcohol, which is widely consumed in various social settings, is a depressant, meaning it slows down and dampens activity in the brain. In circumstances where a person is taking antidepressants — a class of medications used to treat mental health disorders by altering the balance of certain brain chemicals — drinking alcohol can produce numerous physical and mental health-related side effects, which can interfere with a person’s recovery from depression and anxiety. Here are the potential risks of mixing alcohol and antidepressants, along with strategies for safely managing alcohol consumption while on such medications.

4 risks of mixing antidepressants and alcohol

Consuming alcohol with antidepressants can lead to a range of serious health risks, as alcohol affects the central nervous system and can counteract the beneficial effects of antidepressant medication via brain chemicals such as dopamine and serotonin. Here are some of the most common side effects of alcohol use while on antidepressants. 

1. Worsening depression and anxiety

Because alcohol is a depressant, even moderate drinking can lead to increased feelings of sadness, hopelessness, or anxiety in people dealing with a mental health condition. For people taking antidepressants, consumption of alcohol can hinder progress in managing their depression and anxiety symptoms by counteracting the impact of the antidepressants. Additionally, alcohol can disrupt sleep patterns and impair cognitive function, making it harder to manage everyday emotional challenges and thus worsening depression or anxiety symptoms. This does not mean a person cannot drink alcohol at all when taking antidepressants; however, how much and how frequently a person drinks should be discussed with their provider. 

2. Increased risk of alcohol dependence

Those struggling with depression or another mood disorder are at a higher risk of developing alcohol dependence or alcohol use disorder, as it can lead to a reliance on alcohol misuse to manage stress or emotional pain. Over time, the pattern of self-medicating with alcohol can both worsen a person’s mental health condition and lead to alcohol abuse, creating a vicious cycle that makes it increasingly difficult to break free from both the addiction and underlying mental health disorder. 

3. Physical side effects

While not only affecting mental health, alcohol interactions with antidepressants can lead to physical side effects. Common symptoms include dizziness, drowsiness, and impaired coordination, which makes it particularly dangerous when driving or operating machinery. When used in moderation and caution, alcohol and antidepressants can be taken together without such effects. Furthermore, when combined with antidepressants, particularly tricyclic antidepressants, alcohol can significantly increase the risk of accidents or overdose due to its sedative effect.

4. Serotonin syndrome 

Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the brain, often due to medication interactions or overdose. The combination of alcohol with antidepressants that increase serotonin levels can lead to this condition, in which case it is important to seek immediate medical attention. Symptoms of serotonin syndrome include confusion, agitation, rapid heart rate, and even seizures, making it crucial to avoid consuming excessive alcohol while taking antidepressants. 

Alcohol’s effect on different antidepressants

The risk of drinking alcohol varies depending on the type of antidepressant a person is taking, as some medications may reduce in effectiveness while some lead to more serious health complications. For those taking selective serotonin reuptake inhibitors (SSRIs), alcohol can reduce the medication’s ability to function properly, increasing feelings of depression or anxiety and increasing the risk of serotonin syndrome. In other cases, people taking monoamine oxidase inhibitors (MAOIs) present a unique danger when mixed with alcohol, as an alcoholic beverage containing tyramine can lead to a dangerous spike in blood pressure, known as a hypertensive crisis. 

Additionally, atypical antidepressants and other medications can lower the seizure threshold, a property shared with alcohol. Therefore, it’s important to understand the specific risks associated with each type of antidepressant before consuming alcohol.

What is alcohol use disorder?

In some cases, people may struggle with compulsive alcohol use despite its harmful effects on health and daily life, otherwise known as alcohol use disorder (AUD). For those taking antidepressants while also struggling with AUD or alcohol addiction, safely managing alcohol consumption is especially challenging due to the intense cravings they feel. AUD is considered chronic and often requires professional treatment, which might include therapy, medication-assisted treatment, or support groups like alcoholics anonymous to help manage and reduce alcohol consumption. 

How to manage alcohol use while taking antidepressants

For those struggling with alcohol consumption who are currently taking antidepressants, it’s important to consult a healthcare provider to develop a safe and effective treatment plan. Here are the two most important strategies for managing alcohol use while on antidepressants. 

1. Limit or avoid alcohol

The safest course of action is to avoid alcohol entirely while taking antidepressants; however, if avoiding alcohol isn’t feasible, it’s important to limit alcohol consumption and avoid binge drinking. Drinking in moderation can help minimize the risk of negative interactions between alcohol and depression medication, as it will have much less of an impact on the medication’s effectiveness. 

2. Monitor side effects

It’s important to be vigilant about side effects when combining alcohol with antidepressants, as some types have more severe side effects than others. Monitoring the body’s response to alcohol use closely and reporting any unusual side effects such as dizziness, drowsiness, or increased depression to a healthcare provider is crucial for ensuring both physical safety and the effectiveness of treatment. 

Combined treatment for co-occurring disorders 

There are often cases in which people have co-occurring disorders, such as depression and alcohol use disorder, making it necessary to address both from a treatment standpoint. These cases present challenges, as alcohol misuse can worsen depression symptoms, while untreated depression can drive excessive alcohol consumption. Effective treatment requires a comprehensive approach that simultaneously addresses both disorders, which often involves cognitive behavioral therapy (CBT), which helps people identify and reframe negative thought patterns and behaviors related to both alcohol use and mental health disorders. 

By addressing both of a person’s disorders through a well-rounded, integrated treatment plan, they can learn to achieve lasting recovery and significantly improve their overall mental health and quality of life. 

How Charlie Health can help

If you or a loved one are struggling with depression or alcohol use disorder, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.